| Our Lady Queen Of Peace Center, Inc. | |
|
909 Jefferson St Jefferson City MO 65101-2945 | |
| (573) 893-6279 | |
| (573) 893-7248 |
| Full Name | Our Lady Queen Of Peace Center, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 909 Jefferson St, Jefferson City, Missouri |
| Authorized Official Name and Position | Carolyn J. Tucker (PRESIDENT) |
| Authorized Official Contact | 5738936279 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Our Lady Queen Of Peace Center, Inc. 909 Jefferson St Jefferson City MO 65101-2945 Ph: (573) 893-6279 | Our Lady Queen Of Peace Center, Inc. 909 Jefferson St Jefferson City MO 65101-2945 Ph: (573) 893-6279 |
| NPI Number | 1962459768 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962459768 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2002014089 (Missouri) | Primary |
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