| Poplar Bluff Primary Care | |
|
2360 Katy Ln Poplar Bluff MO 63901-2300 | |
| (573) 712-2546 | |
| (573) 712-2549 |
| Full Name | Poplar Bluff Primary Care |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 2360 Katy Ln, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Paula Lalor (DIRECTOR/DELEGATED OFFICIAL) |
| Authorized Official Contact | 6292153953 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Poplar Bluff Primary Care 2360 Katy Ln Poplar Bluff MO 63901-2300 Ph: (573) 712-2546 | Poplar Bluff Primary Care 2360 Katy Ln Poplar Bluff MO 63901-2300 Ph: (573) 712-2546 |
| NPI Number | 1225380108 |
|---|---|
| Provider Enumeration Date | 10/03/2012 |
| Last Update Date | 04/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225380108 | NPI | - | NPPES |
| 268685 | Other | MO | MEDICARE OSCAR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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