| Jefferson Medical Group | |
|
105 E 2nd St Norborne MO 64668-1301 | |
| (660) 593-3623 | |
| (660) 593-3628 |
| Full Name | Jefferson Medical Group |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 105 E 2nd St, Norborne, Missouri |
| Authorized Official Name and Position | Amy Danielle Ireland (CFO) |
| Authorized Official Contact | 6603296005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Medical Group 1502 N Jefferson St Carrollton MO 64633-1948 Ph: (660) 542-9998 | Jefferson Medical Group 105 E 2nd St Norborne MO 64668-1301 Ph: (660) 593-3623 |
| NPI Number | 1467742452 |
|---|---|
| Provider Enumeration Date | 04/12/2011 |
| Last Update Date | 10/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467742452 | NPI | - | NPPES |
| 596573204 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Missouri) | Primary |