| Midwest Ob Gyn Of Missouri, Llc | |
|
2210 Barron Rd Ste 206 Poplar Bluff MO 63901-1908 | |
| (573) 772-7000 | |
| Not Available |
| Full Name | Midwest Ob Gyn Of Missouri, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2210 Barron Rd Ste 206, Poplar Bluff, Missouri |
| Authorized Official Name and Position | John R Patty (OWNER/PHYSICIAN) |
| Authorized Official Contact | 5737727000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Ob Gyn Of Missouri, Llc Po Box 1007 Poplar Bluff MO 63902-1007 Ph: (573) 772-7000 | Midwest Ob Gyn Of Missouri, Llc 2210 Barron Rd Ste 206 Poplar Bluff MO 63901-1908 Ph: (573) 772-7000 |
| NPI Number | 1396337473 |
|---|---|
| Provider Enumeration Date | 02/09/2021 |
| Last Update Date | 03/05/2021 |
| Medicare PECOS PAC ID | 3870853294 |
|---|---|
| Medicare Enrollment ID | O20210430000555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396337473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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