| Mercy Clinic Family Medicine-birch Tree | |
|
9138 O'banion St Birch Tree MO 65438 | |
| (573) 292-3213 | |
| (573) 292-4442 |
| Full Name | Mercy Clinic Family Medicine-birch Tree |
|---|---|
| Speciality | Clinic/Center |
| Location | 9138 O'banion St, Birch Tree, Missouri |
| Authorized Official Name and Position | Robert Cavagnol (CHIEF PHYSICIAN OFFICER) |
| Authorized Official Contact | 4178202705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Clinic Family Medicine-birch Tree 645 Maryville Centre Dr Fl 3 Saint Louis MO 63141-5855 Ph: (417) 820-7133 | Mercy Clinic Family Medicine-birch Tree 9138 O'banion St Birch Tree MO 65438 Ph: (573) 292-3213 |
| NPI Number | 1811065477 |
|---|---|
| Provider Enumeration Date | 12/01/2006 |
| Last Update Date | 05/14/2019 |
| Medicare PECOS PAC ID | 7416865845 |
|---|---|
| Medicare Enrollment ID | O20100219000232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811065477 | NPI | - | NPPES |
| 592365407 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | R7838 (Missouri) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (Missouri) | Primary |
Mercy Clinic Birch Tree Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Highway 99 And O'banion St, Birch Tree, MO 65438 Phone: 573-292-3214 |