Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 221 N Main St, Paris, Missouri |
Authorized Official Name and Position | Robert B. Vanconia (PRESIDENT/CEO) |
Authorized Official Contact | 5735828108 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
221 N Main St Paris MO 65275-1328 Ph: (660) 327-4000 | 221 N Main St Paris MO 65275-1328 Ph: (660) 327-4000 |
NPI Number | 1548520026 |
---|---|
Provider Enumeration Date | 05/18/2012 |
Last Update Date | 05/08/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548520026 | NPI | - | NPPES |
1548520026 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
The Sutherland Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 221 N Main St, Paris, MO 65275 Phone: 660-327-6416 Fax: 660-327-6217 |