| |
212 College St Pilot Grove MO 65276-1005 | |
(660) 834-5100 | |
(660) 834-5101 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 212 College St, Pilot Grove, Missouri |
Authorized Official Name and Position | Amelia D Ledbetter (DIRECTOR OF OPERATIONS) |
Authorized Official Contact | 5733354715 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
212 College St Pilot Grove MO 65276-1005 Ph: (660) 834-5100 | 212 College St Pilot Grove MO 65276-1005 Ph: (660) 834-5100 |
NPI Number | 1669831640 |
---|---|
Provider Enumeration Date | 02/18/2016 |
Last Update Date | 02/18/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669831640 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |