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301 N Highway 21 Pilot Knob MO 63663-7862 | |
(573) 546-8051 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 301 N Highway 21, Pilot Knob, Missouri |
Authorized Official Name and Position | Kayla Chamberlain (CFO) |
Authorized Official Contact | 5735468051 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 548 301 North Highway 21 Pilot Knob MO 63663-0548 Ph: (573) 546-1260 | 301 N Highway 21 Pilot Knob MO 63663-7862 Ph: (573) 546-8051 |
NPI Number | 1073799367 |
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Provider Enumeration Date | 01/16/2008 |
Last Update Date | 02/05/2024 |
Medicare PECOS PAC ID | 0941207526 |
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Medicare Enrollment ID | O20091008000706 |
Identifier | Type | State | Issuer |
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1073799367 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Boonyasai & Boonyasai, M.d.p. C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 St . Marys Street, Lower Level, Pilot Knob, MO 63663 Phone: 573-546-3929 Fax: 573-546-3962 | |