| Physicians Park Primary Care | |
|
225 Physicians Park Suite 400 Poplar Bluff MO 63901-3956 | |
| (573) 727-5500 | |
| (573) 778-0581 |
| Full Name | Physicians Park Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 225 Physicians Park, Poplar Bluff, Missouri |
| Authorized Official Name and Position | F. Michael Caldwell (PHYSICIAN) |
| Authorized Official Contact | 5737275500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Physicians Park Primary Care 225 Physicians Park Suite 400 Poplar Bluff MO 63901-3956 Ph: (573) 727-5500 | Physicians Park Primary Care 225 Physicians Park Suite 400 Poplar Bluff MO 63901-3956 Ph: (573) 727-5500 |
| NPI Number | 1629022215 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 11/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629022215 | NPI | - | NPPES |
| 505183400 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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