| Midwest Medical Practitioners Llc | |
| 
					120 Boyd St Desoto MO 63020  | |
| (636) 282-0380 | |
| (877) 592-0806 | 
| Full Name | Midwest Medical Practitioners Llc | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 120 Boyd St, Desoto, Missouri | 
| Authorized Official Name and Position | Danish A Jabbar (OWNER) | 
| Authorized Official Contact | 6362820380 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Midwest Medical Practitioners Llc 1153 E Gannon Dr Festus MO 63028-2611 Ph: (636) 282-0380  | Midwest Medical Practitioners Llc 120 Boyd St Desoto MO 63020 Ph: (636) 282-0380  | 
| NPI Number | 1174260111 | 
|---|---|
| Provider Enumeration Date | 05/19/2022 | 
| Last Update Date | 05/19/2022 | 
| Medicare PECOS PAC ID | 8729398425 | 
|---|---|
| Medicare Enrollment ID | O20221117000472 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1174260111 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary | 
Steven Crawford Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12 Jefferson Sq, Desoto, MO 63020 Phone: 636-586-6685 Fax: 636-586-2780  |