DOCTORS INN CLINIC LLC NPI 1114117306

NPI Information

  • NPI: 1114117306
  • Provider Name: DOCTORS INN CLINIC LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 1112 SOUTH BYP STE C
    SUITE C
    KENNETT, MO
    ZIP 63857
  • Phone: (573) 717-1776

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NPI Details

DOCTORS INN CLINIC LLC is a family medicine in Kennett, 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. DOCTORS INN CLINIC LLC NPI is 1114117306. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1112 SOUTH BYP STE C
SUITE C
KENNETT, MO
ZIP 63857-738
Phone: (573) 717-1776
Fax: (573) 717-1572

The provider's authorized official is Debbie A Wade .
The authorized official title is Np and has the following contact phone number (573) 717-1776.

The enumeration date for this NPI number is 7/25/2007 and was last updated on 2/26/2010.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine2000148413MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1150606001OTHERMISSOURIARKANSAS MEDICAID
2000094864MEDICARE PINMISSOURI
3263907MEDICARE PINMISSOURI
4SM707OTHERMISSOURIBLUE CROSS ARKANSAS
5595409004MEDICAIDMISSOURI
6G89308MEDICARE UPINMISSOURI
7263907MEDICARE OSCAR/CERTIFICATIONMISSOURI
8109494A-001OTHERMISSOURIBLUE CROSS MISSOURI

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: 11/21/2025

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