| State Of Missouri | |
|
100 West 1st St Higginsville MO 64037 | |
| (660) 584-2142 | |
| (660) 584-6244 |
| Full Name | State Of Missouri |
|---|---|
| Speciality | Family Medicine |
| Location | 100 West 1st St, Higginsville, Missouri |
| Authorized Official Name and Position | Molly Jane Boeckmann (DIRECTOR OF ADMINISTRATIVE SERVICES) |
| Authorized Official Contact | 5737514055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State Of Missouri 1706 E Elm St Jefferson City MO 65101-4130 Ph: (573) 751-3398 | State Of Missouri 100 West 1st St Higginsville MO 64037 Ph: (660) 584-2142 |
| NPI Number | 1407803851 |
|---|---|
| Provider Enumeration Date | 05/30/2006 |
| Last Update Date | 10/27/2020 |
| Certification Date | 10/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407803851 | NPI | - | NPPES |
| 501499701 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Whidbey Island Public Hospital District Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 19203 Hazel Dell Rd, Higginsville, MO 64037 Phone: 360-678-5151 | |
Assent Aba Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 609 W 22nd St, Higginsville, MO 64037 Phone: 209-496-7223 |