| |
102 E Marion St Paris MO 65275-1041 | |
(660) 327-4911 | |
(660) 327-5501 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 102 E Marion St, Paris, Missouri |
Authorized Official Name and Position | Mary Jo Crawford (OWNER) |
Authorized Official Contact | 6603274911 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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102 E Marion St Paris MO 65275-1041 Ph: (660) 327-4911 | 102 E Marion St Paris MO 65275-1041 Ph: (660) 327-4911 |
NPI Number | 1982781530 |
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Provider Enumeration Date | 11/01/2006 |
Last Update Date | 01/28/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982781530 | NPI | - | NPPES |
080187042 | Other | RAILROAD MEDICARE | |
242583102 | Medicaid | MO | |
599120102 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | R2J93 (Missouri) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
The Sutherland Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 221 N Main St, Paris, MO 65275 Phone: 660-327-6416 Fax: 660-327-6217 |