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NPI Code Detail

MEDICARE: POPLAR BLUFF REGIONAL MEDICAL CENTER, LLC

MEDICARE: POPLAR BLUFF REGIONAL MEDICAL CENTER, 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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1841606860
Entity Type Code : Organization
Provider Name (Legal Business Name) : POPLAR BLUFF REGIONAL MEDICAL CENTER, LLC
Provider Business Mailing Address
First Line : PO BOX 689022
Second Line :
City : FRANKLIN
State : TN
Zip : 37068-9022
Country : US
Telephone Number : 615-465-7000
Fax Number : 615-465-3007
Provider Business Practice Location Address
First Line : 806 N DOUGLASS ST
Second Line :
City : MALDEN
State : MO
Zip : 63863-1512
Country : US
Telephone Number : 573-276-3873
Fax Number : 573-276-2625
Authorized Official
Title or Position : SR. DIRECTOR
Name : JAMES P WRIGHT
Credential :
Telephone Number : 615-465-7587
Provider Enumeration Date : 07/10/2014
Last Update Date : 07/29/2014

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1801839147 — POPLAR BLUFF REGIONAL MEDICAL CENTER LLC
Practice Location Address:
806 N DOUGLASS ST
MALDEN, MO
63863-1512
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1215293378 — MRS. SHARON DENISE WHITE FNP
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1457741332 — JANE ANNI MD
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806 N DOUGLASS ST
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1356061121 — MRS. JENNETTA SUE STEARNS FNP
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