| Poplar Bluff Pediatric Assoc Ll | |
|
2210 Barron Rd Poplar Bluff MO 63901-1908 | |
| (573) 785-2005 | |
| (573) 785-9444 |
| Full Name | Poplar Bluff Pediatric Assoc Ll |
|---|---|
| Speciality | Clinic/center |
| Location | 2210 Barron Rd, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Tiffany L Moss (OFFICE MANAGER) |
| Authorized Official Contact | 5737852005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Poplar Bluff Pediatric Assoc Ll 2210 Barron Rd Poplar Bluff MO 63901-1908 Ph: (573) 785-2005 | Poplar Bluff Pediatric Assoc Ll 2210 Barron Rd Poplar Bluff MO 63901-1908 Ph: (573) 785-2005 |
| NPI Number | 1457881963 |
|---|---|
| Provider Enumeration Date | 06/16/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457881963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
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