| Physician Management Services Of Southern Missouri, Llc | |
|
1002 Peruque Crossing Ct O Fallon MO 63366-2362 | |
| (888) 829-8550 | |
| Not Available |
| Full Name | Physician Management Services Of Southern Missouri, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1002 Peruque Crossing Ct, O Fallon, Missouri |
| Authorized Official Name and Position | Brett Kenefick (PRESIDENT) |
| Authorized Official Contact | 8888298550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Management Services Of Southern Missouri, Llc 3113 Lawton Rd Ste 250 Orlando FL 32803-3517 Ph: () - | Physician Management Services Of Southern Missouri, Llc 1002 Peruque Crossing Ct O Fallon MO 63366-2362 Ph: (888) 829-8550 |
| NPI Number | 1164932893 |
|---|---|
| Provider Enumeration Date | 10/09/2017 |
| Last Update Date | 10/09/2017 |
| Medicare PECOS PAC ID | 8921334954 |
|---|---|
| Medicare Enrollment ID | O20190729001018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164932893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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