| Conway Family Clinic, Inc. | |
|
301 South Newport Avenue Conway MO 65632-0009 | |
| (417) 589-2050 | |
| (417) 589-4046 |
| Full Name | Conway Family Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 South Newport Avenue, Conway, Missouri |
| Authorized Official Name and Position | Dee Twyman (PRESIDENT) |
| Authorized Official Contact | 4175892050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conway Family Clinic, Inc. 301 S Newport Ave Po Box 9 Conway MO 65632-8322 Ph: (417) 589-2050 | Conway Family Clinic, Inc. 301 South Newport Avenue Conway MO 65632-0009 Ph: (417) 589-2050 |
| NPI Number | 1013993898 |
|---|---|
| Provider Enumeration Date | 12/22/2005 |
| Last Update Date | 12/30/2009 |
| Medicare PECOS PAC ID | 8527012103 |
|---|---|
| Medicare Enrollment ID | O20050307000384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013993898 | NPI | - | NPPES |
| 598899201 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Deanna Twyman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164408399 PECOS PAC ID: 5395745129 Enrollment ID: I20100722000692 |
| Provider Name | Loridan Bromberek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992173637 PECOS PAC ID: 9638479488 Enrollment ID: I20170816000517 |
Conway Family Clinic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 S. Newport, Conway, MO 65632 Phone: 417-589-2050 Fax: 417-589-4046 |