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624 E Mount Vernon Blvd Mount Vernon MO 65712-9100 | |
(417) 269-2460 | |
(417) 269-2462 |
Full Name | |
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Speciality | Family Medicine |
Location | 624 E Mount Vernon Blvd, Mount Vernon, Missouri |
Authorized Official Name and Position | David P Taylor (VICE PRESIDENT) |
Authorized Official Contact | 4172696262 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3800 S National Ave Ste 540 Springfield MO 65807-5209 Ph: (417) 269-5712 | 624 E Mount Vernon Blvd Mount Vernon MO 65712-9100 Ph: (417) 269-2460 |
NPI Number | 1407021314 |
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Provider Enumeration Date | 04/23/2008 |
Last Update Date | 04/23/2008 |
Identifier | Type | State | Issuer |
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1407021314 | NPI | - | NPPES |
508603909 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Oncare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 918 Sunshine Dr, Mount Vernon, MO 65712 Phone: 417-553-9583 Fax: 417-553-9585 | |