Healthcare Provider Details

I. General information

NPI: 1295707693
Provider Name (Legal Business Name): JAN FINNEY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 06/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 BUCHANAN HWY 50 W
CALIFORNIA MO
65018
US

IV. Provider business mailing address

704 BUCHANAN HWY 50 W, CAPITAL REGION MEDICAL CLINIC CALIFORNIA
CALIFORNIA MO
65018
US

V. Phone/Fax

Practice location:
  • Phone: 573-796-3111
  • Fax: 573-796-3042
Mailing address:
  • Phone: 573-796-3111
  • Fax: 573-796-3042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberR5H49
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: