Healthcare Provider Details

I. General information

NPI: 1164037875
Provider Name (Legal Business Name): VISITING PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 09/10/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 E GREEN MEADOWS RD STE 3
COLUMBIA MO
65203-3633
US

IV. Provider business mailing address

108 E GREEN MEADOWS RD STE 3
COLUMBIA MO
65203-3633
US

V. Phone/Fax

Practice location:
  • Phone: 573-289-2657
  • Fax:
Mailing address:
  • Phone: 573-289-2657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BETH ANN SJOBLOM
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 314-277-2847