| |
1015 W Adams St Bowling Green MO 63334-1974 | |
(573) 324-5300 | |
(573) 324-6059 |
Full Name | |
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Speciality | Family Medicine |
Location | 1015 W Adams St, Bowling Green, Missouri |
Authorized Official Name and Position | Justin Selle (CEO) |
Authorized Official Contact | 5737545531 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1015 W Adams St Bowling Green MO 63334-1974 Ph: (573) 324-5300 | 1015 W Adams St Bowling Green MO 63334-1974 Ph: (573) 324-5300 |
NPI Number | 1992159438 |
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Provider Enumeration Date | 04/21/2016 |
Last Update Date | 04/26/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992159438 | NPI | - | NPPES |
000012300 | Other | MO | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Bgmg Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 905 Highway 161, Bowling Green, MO 63334 Phone: 573-324-3333 Fax: 573-324-3334 | |
Naman Ghazal Albar Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 W Church St, Bowling Green, MO 63334 Phone: 573-324-5300 | |