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General NPI Number Information
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NPI Number | 1598747545
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Entity Type | Organization
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Legal Business Name | PECULIAR MEDICAL CLINIC
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 03/03/2008
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Provider Practice Location Address
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Address Line | 300 S MAIN
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City | PECULIAR
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State | MO
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Zip | 64078-9729
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Country | US
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Telephone | 816-779-1100
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Fax | 816-779-1119
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Provider Business Mailing Address
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Address Line | PO BOX 788
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City | PECULIAR
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State | MO
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Zip | 64078-0788
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Country | US
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Telephone | 816-779-1100
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Fax | 816-779-1119
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Authorized Official
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Title or Position | CEO
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Name | MR. JOHN CHRISTOPHER LANG
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Credential |
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Telephone | 816-358-8888
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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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