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902 Custer St Trenton MO 64683-2238 | |
(660) 359-5621 | |
(660) 359-4978 |
Full Name | |
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Speciality | Family Medicine |
Location | 902 Custer St, Trenton, Missouri |
Authorized Official Name and Position | Les Reed (CFO) |
Authorized Official Contact | 6603595621 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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701 E 1st St Trenton MO 64683-2402 Ph: (660) 359-5621 | 902 Custer St Trenton MO 64683-2238 Ph: (660) 359-5621 |
NPI Number | 1992024103 |
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Provider Enumeration Date | 05/27/2010 |
Last Update Date | 05/27/2010 |
Identifier | Type | State | Issuer |
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1992024103 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (Missouri) | Primary |
207VX0000X | Obstetrics & Gynecology - Obstetrics | (Missouri) | Secondary |