| Premier Family Physicians, Lc | |
|
8 Doctors Park Cape Girardeau MO 63703-4928 | |
| (573) 651-1333 | |
| (573) 651-1324 |
| Full Name | Premier Family Physicians, Lc |
|---|---|
| Speciality | General Practice |
| Location | 8 Doctors Park, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Kennneth Dean Phillips (OWNER/PHYSICIAN) |
| Authorized Official Contact | 5736511333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Family Physicians, Lc 8 Doctors Park Cape Girardeau MO 63703-4928 Ph: (573) 651-1333 | Premier Family Physicians, Lc 8 Doctors Park Cape Girardeau MO 63703-4928 Ph: (573) 651-1333 |
| NPI Number | 1316918949 |
|---|---|
| Provider Enumeration Date | 01/31/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 4486820107 |
|---|---|
| Medicare Enrollment ID | O20111230000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316918949 | NPI | - | NPPES |
| 508145604 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (Missouri) | Primary |
| Provider Name | Kenneth D Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053383281 PECOS PAC ID: 4284800905 Enrollment ID: I20111230000389 |
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