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PHYSICIAN SERVICES OF MISSOURI LLC NPI 1164792032


NPI Information

NPI: 1164792032
Provider Name: PHYSICIAN SERVICES OF MISSOURI LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1611 S BALTIMORE ST
KIRKSVILLE, MO
ZIP 63501
Phone: (859) 514-5547
Get Directions

PHYSICIAN SERVICES OF MISSOURI LLC is a family medicine in Kirksville, 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. PHYSICIAN SERVICES OF MISSOURI LLC NPI is 1164792032. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1611 S BALTIMORE ST
KIRKSVILLE, MO
ZIP 63501-536
Phone: (859) 514-5547
Fax: (859) 422-4907

The provider's authorized official is Casey Deloach .
The authorized official title is Manager and has the following contact phone number (888) 829-8550.

The enumeration date for this NPI number is 1/9/2012 and was last updated on 1/9/2012.


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 MedicineYes

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
1PHC059OTHERMEDICARE PTAN

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: 5/5/2024

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