Healthcare Provider Details

I. General information

NPI: 1508578147
Provider Name (Legal Business Name): EAGLE CARE SOLUTIONS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2022
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 CARTER 301A
VAN BUREN MO
63965-5502
US

IV. Provider business mailing address

PO BOX 83
VAN BUREN MO
63965-0083
US

V. Phone/Fax

Practice location:
  • Phone: 618-570-1505
  • Fax:
Mailing address:
  • Phone: 618-570-1505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAMMY J LINDSAY
Title or Position: OWNER
Credential: MD
Phone: 618-570-1505