| Republic Family Health Care | |
|
820 S Illinois Ave Republic MO 65738-1177 | |
| (417) 269-1910 | |
| (417) 269-1916 |
| Full Name | Republic Family Health Care |
|---|---|
| Speciality | Family Medicine |
| Location | 820 S Illinois Ave, Republic, Missouri |
| Authorized Official Name and Position | David P Taylor (VICE PRESIDENT) |
| Authorized Official Contact | 4172696262 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Republic Family Health Care 3800 S National Ave #540 Springfield MO 65807-5209 Ph: (417) 269-6262 | Republic Family Health Care 820 S Illinois Ave Republic MO 65738-1177 Ph: (417) 269-1910 |
| NPI Number | 1609962596 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 06/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609962596 | NPI | - | NPPES |
| 505427609 | Medicaid | MO | |
| 201476 | Other | BLUE CROSS OF MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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