| Midwest Medical Practitioners Llc | |
|
120 Boyd St Desoto MO 63020 | |
| (636) 282-0380 | |
| (877) 592-0806 |
| Full Name | Midwest Medical Practitioners Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 Boyd St, Desoto, Missouri |
| Authorized Official Name and Position | Danish A Jabbar (OWNER) |
| Authorized Official Contact | 6362820380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Medical Practitioners Llc 1153 E Gannon Dr Festus MO 63028-2611 Ph: (636) 282-0380 | Midwest Medical Practitioners Llc 120 Boyd St Desoto MO 63020 Ph: (636) 282-0380 |
| NPI Number | 1174260111 |
|---|---|
| Provider Enumeration Date | 05/19/2022 |
| Last Update Date | 05/19/2022 |
| Medicare PECOS PAC ID | 8729398425 |
|---|---|
| Medicare Enrollment ID | O20221117000472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174260111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Desoto Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12 Jefferson Sq, Desoto, MO 63020 Phone: 636-586-6685 Fax: 636-586-2780 |