| Lake Regional Obstetrics & Gynecology | |
|
54 Hospital Dr Ste 201 Osage Beach MO 65065-3050 | |
| (573) 302-2764 | |
| (573) 302-2767 |
| Full Name | Lake Regional Obstetrics & Gynecology |
|---|---|
| Speciality | Clinic/Center |
| Location | 54 Hospital Dr Ste 201, Osage Beach, Missouri |
| Authorized Official Name and Position | Kevin Mcroberts (CEO) |
| Authorized Official Contact | 5733488756 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Regional Obstetrics & Gynecology Po Box 801661 Kansas City MO 64180-1661 Ph: (573) 348-8000 | Lake Regional Obstetrics & Gynecology 54 Hospital Dr Ste 201 Osage Beach MO 65065-3050 Ph: (573) 302-2764 |
| NPI Number | 1316616212 |
|---|---|
| Provider Enumeration Date | 09/13/2021 |
| Last Update Date | 10/12/2023 |
| Medicare PECOS PAC ID | 9133026776 |
|---|---|
| Medicare Enrollment ID | O20210924000114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316616212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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Lake Regional Clinic - Osage Beach Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1057 Medical Park Dr, Suite A, Osage Beach, MO 65065 Phone: 573-302-3100 Fax: 573-348-8279 | |
Lake Regional Health System Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 54 Hospital Dr, Osage Beach, MO 65065 Phone: 573-348-8000 | |
Jcmg At The Lake Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5816 Osage Beach Pkwy Ste 105, Osage Beach, MO 65065 Phone: 573-348-3001 Fax: 573-348-5998 | |
Lake Regional Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 54 Hospital Dr, Osage Beach, MO 65065 Phone: 573-348-8074 Fax: 573-348-8069 |