Healthcare Provider Details

I. General information

NPI: 1831567577
Provider Name (Legal Business Name): MOHAMMAD JARBOU MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S KEENE ST
COLUMBIA MO
65201-6603
US

IV. Provider business mailing address

100 S KEENE ST
COLUMBIA MO
65201-6603
US

V. Phone/Fax

Practice location:
  • Phone: 573-777-9917
  • Fax: 844-366-3221
Mailing address:
  • Phone: 573-968-6822
  • Fax: 573-227-6436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MOHAMMAD JARBOU
Title or Position: PHYSICIAN
Credential: MD
Phone: 573-639-0292