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General NPI Number Information
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NPI Number | 1871768606
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH MEDICAL
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 825 S HIGHWAY 13
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City | LEXINGTON
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State | MO
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Zip | 64067-1515
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Country | US
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Telephone | 660-259-2240
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Fax | 660-259-2250
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Provider Business Mailing Address
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Address Line | PO BOX 817
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63702-0817
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Country | US
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Telephone | 660-259-2240
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Fax | 660-259-2250
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MRS. AMY D LEDBETTER
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Credential |
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Telephone | 573-651-4488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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