| Northeast Regional Medical Group | |
|
1607 S Baltimore St Kirksville MO 63501-4536 | |
| (660) 627-3363 | |
| Not Available |
| Full Name | Northeast Regional Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 1607 S Baltimore St, Kirksville, Missouri |
| Authorized Official Name and Position | Paula M Lalor (DIRECTOR/DELEGATED OFFICIAL) |
| Authorized Official Contact | 6292153953 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Regional Medical Group 315 S Osteopathy Ave Kirksville MO 63501-6401 Ph: (660) 785-1000 | Northeast Regional Medical Group 1607 S Baltimore St Kirksville MO 63501-4536 Ph: (660) 627-3363 |
| NPI Number | 1508135005 |
|---|---|
| Provider Enumeration Date | 12/29/2011 |
| Last Update Date | 04/08/2021 |
| Medicare PECOS PAC ID | 3274517347 |
|---|---|
| Medicare Enrollment ID | O20120305000406 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508135005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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Northeast Regional Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1607 S Baltimore St, Kirksville, MO 63501 Phone: 660-627-3363 Fax: 660-627-3367 |