| Phelps Health Medical Group | |
|
1050 W 10th St Rolla MO 65401-2905 | |
| (573) 364-9000 | |
| Not Available |
| Full Name | Phelps Health Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 1050 W 10th St, Rolla, Missouri |
| Authorized Official Name and Position | Jana Marie Cook (SR. VP/CFO) |
| Authorized Official Contact | 5734587916 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phelps Health Medical Group Po Box 579 Rolla MO 65402-0579 Ph: (573) 426-2182 | Phelps Health Medical Group 1050 W 10th St Rolla MO 65401-2905 Ph: (573) 364-9000 |
| NPI Number | 1366066037 |
|---|---|
| Provider Enumeration Date | 05/29/2020 |
| Last Update Date | 02/01/2023 |
| Medicare PECOS PAC ID | 2860391158 |
|---|---|
| Medicare Enrollment ID | O20230303002223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366066037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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