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MT. AUBURN MEDICAL GROUP LLC NPI 1306017769


NPI Information

NPI: 1306017769
Provider Name: MT. AUBURN MEDICAL GROUP, LLC

Other Name: MT. AUBURN MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
150 S MOUNT AUBURN RD
SUITE 342
CAPE GIRARDEAU, MO
ZIP 63703
Phone: (573) 335-2212
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MT. AUBURN MEDICAL GROUP, 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. MT. AUBURN MEDICAL GROUP, LLC NPI is 1306017769. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Mt. Auburn Medical Group.

The provider's business location address is:

150 S MOUNT AUBURN RD
SUITE 342
CAPE GIRARDEAU, MO
ZIP 63703-911
Phone: (573) 335-2212
Fax: (573) 339-5946

The provider's authorized official is Robert D Bieser .
The authorized official title is Physician and has the following contact phone number (573) 335-2212.

The enumeration date for this NPI number is 3/13/2008 and was last updated on 3/13/2008.


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 Medicine1004971MISSOURINo
2207R00000XInternal Medicine116768MISSOURINo
3207Q00000XFamily Medicine104929MISSOURIYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1F54582MEDICARE UPINMISSOURI
2H00955MEDICARE UPINMISSOURI
31467542571OTHERMISSOURIPHILIP E. TIPPEN, MD
41174611966OTHERMISSOURIJEFFREY W. CHILDERS, MD
51386732196OTHERMISSOURIROBERT D. BIESER, DO
6H37154MEDICARE UPINMISSOURI

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: 4/28/2024

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