| Grace Family Medical Clinic, Llc | |
| 
					1206 Ward Ave Caruthersville MO 63830-2204  | |
| (573) 922-5111 | |
| (573) 922-5126 | 
| Full Name | Grace Family Medical Clinic, Llc | 
|---|---|
| Speciality | Internal Medicine | 
| Location | 1206 Ward Ave, Caruthersville, Missouri | 
| Authorized Official Name and Position | Joseph M Kulpeksa (OWNER) | 
| Authorized Official Contact | 5739225111 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Grace Family Medical Clinic, Llc 1206 Ward Ave Caruthersville MO 63830-2204 Ph: (573) 922-5111  | Grace Family Medical Clinic, Llc 1206 Ward Ave Caruthersville MO 63830-2204 Ph: (573) 922-5111  | 
| NPI Number | 1780119651 | 
|---|---|
| Provider Enumeration Date | 04/27/2017 | 
| Last Update Date | 04/27/2017 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1780119651 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | 117451 (Missouri) | Primary | 
Missouri Delta Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 W 12th St, Caruthersville, MO 63830 Phone: 573-575-4181 Fax: 573-575-4180  | |
Pemiscot County Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 106 West 12th St, Caruthersville, MO 63830 Phone: 573-359-1782 Fax: 573-333-4665  | |
Douglas Fitzwater Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 412 Ward Ave, Caruthersville, MO 63830 Phone: 573-333-0033 Fax: 573-333-2522  | |
Wt Regional Medical Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 108 W 15th Street, Caruthersville, MO 63830 Phone: 731-512-1277  | |
Caruthersville Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 412 Ward Ave, Caruthersville, MO 63830 Phone: 579-333-0033 Fax: 573-333-2522  | |
Wt Regional Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 W 15th St, Caruthersville, MO 63830 Phone: 573-333-0033 Fax: 573-333-2522  | |
Southeast Missouri Health Network Primary Care Clinic Medicare: Medicare Enrolled Practice Location: Caruthersville Medical Center, 109 East 5th Street, Caruthersville, MO 63830 Phone: 573-359-9803 Fax: 573-359-0990  |