| Fcc's Family Practice Clinic | |
|
3001 Warrior Ln Poplar Bluff MO 63901-8685 | |
| (573) 686-1200 | |
| (573) 778-9492 |
| Full Name | Fcc's Family Practice Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 3001 Warrior Ln, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Larry Shawn Sando (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 5738885925 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fcc's Family Practice Clinic Po Box 71 925 State Route V V Kennett MO 63857-0071 Ph: (573) 888-5925 | Fcc's Family Practice Clinic 3001 Warrior Ln Poplar Bluff MO 63901-8685 Ph: (573) 686-1200 |
| NPI Number | 1508237926 |
|---|---|
| Provider Enumeration Date | 10/12/2015 |
| Last Update Date | 10/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508237926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
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