Healthcare Provider Details

I. General information

NPI: 1265613814
Provider Name (Legal Business Name): MIDWEST PHYSICIANS CONSULTING GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 MAIN ST C/O RAM CHANDRA
LEXINGTON MO
64067-1345
US

IV. Provider business mailing address

1026 MAIN ST C/O RAM CHANDRA
LEXINGTON MO
64067-1345
US

V. Phone/Fax

Practice location:
  • Phone: 660-259-2216
  • Fax: 660-259-3942
Mailing address:
  • Phone: 660-259-2216
  • Fax: 660-259-3942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateMO

VIII. Authorized Official

Name: DR. RAM CHANDRA
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 660-259-2216