Healthcare Provider Details

I. General information

NPI: 1730173345
Provider Name (Legal Business Name): REGIONAL PRIMARY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 N MOUNT AUBURN RD
CAPE GIRARDEAU MO
63701-3437
US

IV. Provider business mailing address

1111 N MOUNT AUBURN RD
CAPE GIRARDEAU MO
63701-3437
US

V. Phone/Fax

Practice location:
  • Phone: 573-332-6000
  • Fax:
Mailing address:
  • Phone: 573-332-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN VAN EARNHART
Title or Position: FAMILY PRACTICE PROVIDER
Credential: MD
Phone: 573-332-6025