| Vienna Family Practice Clinic | |
|
111 Parkway Vienna MO 65582-8003 | |
| (573) 422-3360 | |
| (573) 422-3391 |
| Full Name | Vienna Family Practice Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 111 Parkway, Vienna, Missouri |
| Authorized Official Name and Position | Keith Edward Segall (OWNER) |
| Authorized Official Contact | 5734223360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vienna Family Practice Clinic 111 Parkway Vienna MO 65582-8003 Ph: (573) 422-3360 | Vienna Family Practice Clinic 111 Parkway Vienna MO 65582-8003 Ph: (573) 422-3360 |
| NPI Number | 1790816759 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 07/31/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790816759 | NPI | - | NPPES |
| 508242708 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D0106518 (Missouri) | Primary |
Phelps Health Medical Group Vienna Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 606 Highway 63 S, Vienna, MO 65582 Phone: 573-422-3636 Fax: 573-422-3434 | |
Vienna Family Practice Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 Parkway, Vienna, MO 65582 Phone: 573-422-3360 Fax: 573-422-3391 | |
Vienna Health Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 606 Highway 63 S, Vienna, MO 65582 Phone: 573-422-3636 Fax: 573-422-3434 |