MEDICARE: FREE MARKET PHYSICIAN HOSPITAL SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	2012025745	MO

General Provider Information

NPI Number	:	1093120560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREE MARKET PHYSICIAN HOSPITAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	4040 LA QUESTA DR
Second Line	:
City	:	NEOSHO
State	:	MO
Zip	:	64850-2849
Country	:	US
Telephone Number	:	417-283-4953
Fax Number	:	417-283-4954

Provider Business Practice Location Address
First Line	:	4040 LA QUESTA DR
Second Line	:
City	:	NEOSHO
State	:	MO
Zip	:	64850-2849
Country	:	US
Telephone Number	:	417-283-4953
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSEPH K SHEPPARD
Credential	:	D.O.
Telephone Number	:	417-283-4953

Provider Enumeration Date	:	06/24/2014
Last Update Date	:	11/29/2023

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