| Fcc Primary Care Clinic Poplar Bluff | |
|
3001 Warrior Ln Poplar Bluff MO 63901-8685 | |
| (573) 686-1200 | |
| (573) 778-9492 |
| Full Name | Fcc Primary Care Clinic Poplar Bluff |
|---|---|
| Speciality | Internal Medicine |
| Location | 3001 Warrior Ln, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Tracy Ellis (CCO) |
| Authorized Official Contact | 5738885925 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fcc Primary Care Clinic Poplar Bluff Po Box 71 Kennett MO 63857-0071 Ph: () - | Fcc Primary Care Clinic Poplar Bluff 3001 Warrior Ln Poplar Bluff MO 63901-8685 Ph: (573) 686-1200 |
| NPI Number | 1215510490 |
|---|---|
| Provider Enumeration Date | 05/04/2021 |
| Last Update Date | 07/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215510490 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
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