| Executive Pulmonary Medicine, Pc | |
|
1906a Greenwood Dr Poplar Bluff MO 63901-2430 | |
| (573) 776-7740 | |
| (573) 776-7750 |
| Full Name | Executive Pulmonary Medicine, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1906a Greenwood Dr, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Dennis Daniels (OWNER) |
| Authorized Official Contact | 5737767740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Pulmonary Medicine, Pc Po Box 1087 Poplar Bluff MO 63902-1087 Ph: (573) 785-4601 | Executive Pulmonary Medicine, Pc 1906a Greenwood Dr Poplar Bluff MO 63901-2430 Ph: (573) 776-7740 |
| NPI Number | 1720041197 |
|---|---|
| Provider Enumeration Date | 04/07/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720041197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 2003009194 (Missouri) | Primary |
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