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General NPI Number Information
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NPI Number | 1467850073
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Entity Type | Organization
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Legal Business Name | MIDWEST PHYSICIAN SERVICES, LLC
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Dates
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Enumeration Date | 12/12/2014
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Last Update Date | 12/16/2014
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Provider Practice Location Address
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Address Line | 1702 N BALTIMORE ST
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City | KIRKSVILLE
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State | MO
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Zip | 63501-2485
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Country | US
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Telephone | 660-665-6262
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Fax | 660-665-5908
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Provider Business Mailing Address
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Address Line | 1702 N BALTIMORE ST
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City | KIRKSVILLE
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State | MO
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Zip | 63501-2485
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Country | US
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Telephone | 660-665-6262
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Fax | 660-665-5908
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. JOSEPH GIRA
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Credential | M.D.
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Telephone | 660-665-6262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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