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EBO MD LLC NPI 1326503376


NPI Information

NPI: 1326503376
Provider Name: EBO MD LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 26D2139419

Address:
1417 N MOUNT AUBURN RD STE A
CAPE GIRARDEAU, MO
ZIP 63701
Phone: (573) 803-2941
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EBO MD LLC is a family medicine in Cape Girardeau, MO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EBO MD LLC NPI is 1326503376. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1417 N MOUNT AUBURN RD STE A
CAPE GIRARDEAU, MO
ZIP 63701-171
Phone: (573) 803-2941
Fax: (573) 803-0815

The provider's authorized official is Genni L Ourth .
The authorized official title is Manager and has the following contact phone number (573) 803-2941.

The CLIA number assigned to this NPI record is 26D2139419 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/4/2019 and was last updated on 2/4/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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