| Theodosia Family Medical Clinic Llc | |
|
4900 St Hwy. 160 Suite 2 Theodosia MO 65761-6539 | |
| (417) 273-2300 | |
| (417) 273-2316 |
| Full Name | Theodosia Family Medical Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4900 St Hwy. 160, Theodosia, Missouri |
| Authorized Official Name and Position | Lisa A Schofield (OWNER OF CLINIC) |
| Authorized Official Contact | 4172732300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Theodosia Family Medical Clinic Llc 4900 St Hwy 160 Suite 2 Theodosia MO 65761-6539 Ph: (417) 273-2300 | Theodosia Family Medical Clinic Llc 4900 St Hwy. 160 Suite 2 Theodosia MO 65761-6539 Ph: (417) 273-2300 |
| NPI Number | 1316205206 |
|---|---|
| Provider Enumeration Date | 04/27/2012 |
| Last Update Date | 09/04/2013 |
| Medicare PECOS PAC ID | 3779735329 |
|---|---|
| Medicare Enrollment ID | O20121206000420 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316205206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Samuel Aaron Newton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366511289 PECOS PAC ID: 4587794961 Enrollment ID: I20100610001005 |
| Provider Name | Cathryn Lue Beggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215500681 PECOS PAC ID: 8820338247 Enrollment ID: I20240523000304 |
Theodosia Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Us Highway 160, #1, Theodosia, MO 65761 Phone: 417-273-4449 Fax: 417-273-4489 |