| Prime Time Physicians, Llc | |
|
217 W Reed St Ste A5 Moberly MO 65270 | |
| (573) 268-5725 | |
| (877) 673-1509 |
| Full Name | Prime Time Physicians, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 217 W Reed St, Moberly, Missouri |
| Authorized Official Name and Position | Ayaaz Habibullah (OWNER) |
| Authorized Official Contact | 5732685725 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Time Physicians, Llc 1605 Keegan Ct Columbia MO 65203-6252 Ph: (573) 268-5725 | Prime Time Physicians, Llc 217 W Reed St Ste A5 Moberly MO 65270 Ph: (573) 268-5725 |
| NPI Number | 1215787700 |
|---|---|
| Provider Enumeration Date | 03/26/2024 |
| Last Update Date | 09/23/2024 |
| Medicare PECOS PAC ID | 1557803731 |
|---|---|
| Medicare Enrollment ID | O20240603003194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215787700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ayaaz Anees Habibullah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063932002 PECOS PAC ID: 5092081240 Enrollment ID: I20201014003836 |
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