| Trinity Healthcare Pc | |
|
2740 N Mayfair Ave Springfield MO 65803-5084 | |
| (417) 521-3925 | |
| Not Available |
| Full Name | Trinity Healthcare Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2740 N Mayfair Ave, Springfield, Missouri |
| Authorized Official Name and Position | John Abraham (INCORPORATOR/SHAREHOLDER) |
| Authorized Official Contact | 4176191329 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trinity Healthcare Pc 2740 N Mayfair Ave Springfield MO 65803-5084 Ph: (417) 521-3925 | Trinity Healthcare Pc 2740 N Mayfair Ave Springfield MO 65803-5084 Ph: (417) 521-3925 |
| NPI Number | 1215281761 |
|---|---|
| Provider Enumeration Date | 11/06/2012 |
| Last Update Date | 11/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215281761 | NPI | - | NPPES |
| 1760595136 | Other | PERSONAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD115778 (Missouri) | Primary |
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