Physician Services Of Missouri Llc

LBN: Physician Services Of Missouri Llc
Physician Services Of Missouri Llc is an health care organization with primary practice located at 1611 S Baltimore St , Kirksville MO 63501-4536. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Physician Services Of Missouri Llc can be contacted via phone (859) 514-5547, or through Deloach, Casey via phone (888) 829-8550.

Contact Information

Primary practice address
1611 S Baltimore St Kirksville MO 63501-4536
Phone: (859) 514-5547
Fax: (859) 422-4907
Website:
Map and Directions
Authorized official contact:
Name: Deloach, Casey
Phone: (888) 829-8550

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1164792032
LBN Legal business name Physician Services Of Missouri Llc
DBA Doing business as
Authorized official Deloach, Casey
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 9th, 2012
Last updated Jan 9th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164792032 NPPES
Other PHC059 MEDICARE PTAN

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