| Professional Care Providers, Llc | |
|
723 1st Capitol Dr Saint Charles MO 63301-2729 | |
| (636) 577-1357 | |
| Not Available |
| Full Name | Professional Care Providers, Llc |
|---|---|
| Speciality | Physician Assistant |
| Location | 723 1st Capitol Dr, Saint Charles, Missouri |
| Authorized Official Name and Position | Ray Bartlett (PRESIDENT) |
| Authorized Official Contact | 6365771357 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Care Providers, Llc 2025 Zumbehl Rd #45 Saint Charles MO 63303-2723 Ph: (636) 577-1357 | Professional Care Providers, Llc 723 1st Capitol Dr Saint Charles MO 63301-2729 Ph: (636) 577-1357 |
| NPI Number | 1821001918 |
|---|---|
| Provider Enumeration Date | 08/13/2006 |
| Last Update Date | 04/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821001918 | NPI | - | NPPES |
| DE8055 | Other | MO | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 33327 (Missouri) | Secondary |
| 363A00000X | Physician Assistant | 104933 (Missouri) | Primary |
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