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General NPI Number Information
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NPI Number | 1083380315
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Entity Type | Organization
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Legal Business Name | MIDWEST TOTAL URGENT CARE, LLC
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 8 N FRENCH LN
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City | PERRYVILLE
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State | MO
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Zip | 63775-1577
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Country | US
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Telephone | 573-768-6986
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Fax | 949-655-8621
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Provider Business Mailing Address
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Address Line | 8 N FRENCH LN
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City | PERRYVILLE
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State | MO
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Zip | 63775-1577
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Country | US
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Telephone | 573-768-6986
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Fax | 949-655-8621
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | LANDON BESAND
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Credential |
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Telephone | 573-768-6986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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