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513 N Olive St Queen City MO 63561-1054 | |
(660) 766-2300 | |
(626) 593-4791 |
Full Name | |
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Speciality | Clinic/Center |
Location | 513 N Olive St, Queen City, Missouri |
Authorized Official Name and Position | Julia E Mcnabb (OWNER) |
Authorized Official Contact | 6606265413 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 40 Queen City MO 63561-0040 Ph: (660) 766-2300 | 513 N Olive St Queen City MO 63561-1054 Ph: (660) 766-2300 |
NPI Number | 1154525053 |
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Provider Enumeration Date | 06/13/2007 |
Last Update Date | 10/25/2021 |
Medicare PECOS PAC ID | 8224138409 |
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Medicare Enrollment ID | O20070717000703 |
Identifier | Type | State | Issuer |
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1154525053 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Julia E Mcnabb |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669532727 PECOS PAC ID: 2961502141 Enrollment ID: I20070717000697 |