| Crenshaw Family Practice Clinic, Pc | |
|
133 E Main Kahoka MO 63445-1775 | |
| (660) 727-3388 | |
| (660) 727-2196 |
| Full Name | Crenshaw Family Practice Clinic, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 133 E Main, Kahoka, Missouri |
| Authorized Official Name and Position | Neville Q. Crenshaw (OWNER) |
| Authorized Official Contact | 6607273388 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crenshaw Family Practice Clinic, Pc 133 E Main Kahoka MO 63445 Ph: (660) 727-3388 | Crenshaw Family Practice Clinic, Pc 133 E Main Kahoka MO 63445-1775 Ph: (660) 727-3388 |
| NPI Number | 1073739439 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 01/15/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073739439 | NPI | - | NPPES |
| 242028900 | Medicaid | MO | |
| 000002704 | Other | MO | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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