| Republic Family Medicine, Llc | |
|
117 W State Highway 174 Republic MO 65738-1036 | |
| (417) 647-5131 | |
| (417) 647-5168 |
| Full Name | Republic Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 117 W State Highway 174, Republic, Missouri |
| Authorized Official Name and Position | Yvonne Marie Agius (MEMBER) |
| Authorized Official Contact | 4178240914 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Republic Family Medicine, Llc 117 W State Highway 174 Republic MO 65738-1036 Ph: (417) 647-5131 | Republic Family Medicine, Llc 117 W State Highway 174 Republic MO 65738-1036 Ph: (417) 647-5131 |
| NPI Number | 1679980502 |
|---|---|
| Provider Enumeration Date | 07/11/2014 |
| Last Update Date | 10/02/2023 |
| Medicare PECOS PAC ID | 0042532814 |
|---|---|
| Medicare Enrollment ID | O20141205000315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679980502 | NPI | - | NPPES |
| 1699724708 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Yvonne M Agius |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699724708 PECOS PAC ID: 5890707798 Enrollment ID: I20060614000143 |
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