| Phelps Health Medical Group Vienna | |
|
606 Highway 63 S Vienna MO 65582-8101 | |
| (573) 422-3636 | |
| (573) 422-3434 |
| Full Name | Phelps Health Medical Group Vienna |
|---|---|
| Speciality | Clinic/Center |
| Location | 606 Highway 63 S, Vienna, Missouri |
| Authorized Official Name and Position | Jana M Cook (VP, CHIEF FINANCIAL OFFICER) |
| 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 Vienna Po Box 579 Rolla MO 65402 Ph: (573) 426-2182 | Phelps Health Medical Group Vienna 606 Highway 63 S Vienna MO 65582-8101 Ph: (573) 422-3636 |
| NPI Number | 1114235041 |
|---|---|
| Provider Enumeration Date | 09/14/2010 |
| Last Update Date | 01/17/2019 |
| Medicare PECOS PAC ID | 1557454063 |
|---|---|
| Medicare Enrollment ID | O20100701000579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114235041 | NPI | - | NPPES |
| 594328304 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 2007024375 (Missouri) | Primary |
Vienna Family Practice Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 Parkway, Vienna, MO 65582 Phone: 573-422-3360 Fax: 573-422-3391 | |
Vienna Family Practice Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 Parkway, Vienna, MO 65582 Phone: 573-422-3360 Fax: 573-422-3391 | |
Vienna Health Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 606 Highway 63 S, Vienna, MO 65582 Phone: 573-422-3636 Fax: 573-422-3434 |