Mullock Health Care Llc | |
2332 S Main St Maryville MO 64468-3622 | |
(660) 562-2223 | |
(660) 562-2230 |
Full Name | Mullock Health Care Llc |
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Speciality | Clinic/Center |
Location | 2332 S Main St, Maryville, Missouri |
Authorized Official Name and Position | Dallas Wayne Mullock (OWNER) |
Authorized Official Contact | 6605622223 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mullock Health Care Llc 2332 S Main St Maryville MO 64468-3622 Ph: (660) 562-2223 | Mullock Health Care Llc 2332 S Main St Maryville MO 64468-3622 Ph: (660) 562-2223 |
NPI Number | 1881224707 |
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Provider Enumeration Date | 01/20/2020 |
Last Update Date | 05/06/2024 |
Medicare PECOS PAC ID | 4587091541 |
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Medicare Enrollment ID | O20200304000180 |
Identifier | Type | State | Issuer |
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1881224707 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | William P Triplett |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1730196080 PECOS PAC ID: 8224056247 Enrollment ID: I20051108001108 |
Provider Name | Travis T Hawks |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1700053444 PECOS PAC ID: 9032332606 Enrollment ID: I20140529000624 |
Provider Name | Dallas W Mullock |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1134504012 PECOS PAC ID: 5496182453 Enrollment ID: I20200304000229 |
Continuum Family Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2336 S Main St, Maryville, MO 64468 Phone: 660-220-2123 | |