| Mercy Clinic-lebanon-family Medicine | |
|
120 Hospital Dr Suite 100 Lebanon MO 65536 | |
| (417) 533-6751 | |
| (417) 533-6755 |
| Full Name | Mercy Clinic-lebanon-family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 Hospital Dr, Lebanon, 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-lebanon-family Medicine 645 Maryville Centre Dr Fl 3 Saint Louis MO 63141-5855 Ph: (417) 820-7133 | Mercy Clinic-lebanon-family Medicine 120 Hospital Dr Suite 100 Lebanon MO 65536 Ph: (417) 533-6751 |
| NPI Number | 1447389127 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 12/04/2018 |
| Medicare PECOS PAC ID | 7416865845 |
|---|---|
| Medicare Enrollment ID | O20090603000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447389127 | NPI | - | NPPES |
| 593362700 | Medicaid | MO |
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