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NPI Code Detail

MEDICARE: MEXICO INTERNAL MEDICINE, LLP

MEDICARE: MEXICO INTERNAL MEDICINE, LLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician
2207RP1001XPulmonary Disease Physician

General Provider Information

NPI Number : 1588796254
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEXICO INTERNAL MEDICINE, LLP
Provider Business Mailing Address
First Line : 600 MEDICAL PARK DR
Second Line :
City : MEXICO
State : MO
Zip : 65265-3724
Country : US
Telephone Number : 573-581-8500
Fax Number : 573-581-5397
Provider Business Practice Location Address
First Line : 600 MEDICAL PARK DR
Second Line :
City : MEXICO
State : MO
Zip : 65265-3724
Country : US
Telephone Number : 573-581-8500
Fax Number : 573-581-5397
Authorized Official
Title or Position : ADMINISTRATOR
Name : DIANE HAGEDORN
Credential :
Telephone Number : 573-581-8500
Provider Enumeration Date : 03/09/2007
Last Update Date : 09/11/2025

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Directions to “MEXICO INTERNAL MEDICINE, LLP ” Practice Location

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