| Mid Missouri Medical Consultants, Inc. | |
|
1111 Madison St Jefferson City MO 65101-2753 | |
| (573) 635-7651 | |
| (573) 659-4515 |
| Full Name | Mid Missouri Medical Consultants, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1111 Madison St, Jefferson City, Missouri |
| Authorized Official Name and Position | Nancy Wadley (OFFICE MANAGER) |
| Authorized Official Contact | 5736357651 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid Missouri Medical Consultants, Inc. 1111 Madison St Jefferson City MO 65101-2753 Ph: (573) 635-7651 | Mid Missouri Medical Consultants, Inc. 1111 Madison St Jefferson City MO 65101-2753 Ph: (573) 635-7651 |
| NPI Number | 1740396035 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 02/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740396035 | NPI | - | NPPES |
| 104047 | Other | MO | BC/BS INSURANCE GROUP |
| 500166806 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | R4N29 (Missouri) | Primary |
| 2084N0400X | Psychiatry & Neurology - Neurology | R8638 (Missouri) | Secondary |
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