| Capital Region Physicians - The Sloan Clinic | |
|
1505 Southwest Blvd Jefferson City MO 65109-2431 | |
| (573) 632-5544 | |
| Not Available |
| Full Name | Capital Region Physicians - The Sloan Clinic |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 1505 Southwest Blvd, Jefferson City, Missouri |
| Authorized Official Name and Position | Tom R Luebbering (VP OF FINANCE) |
| Authorized Official Contact | 5736325100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital Region Physicians - The Sloan Clinic 3306 Emerald Ln Suite A Jefferson City MO 65109-6877 Ph: (573) 632-5544 | Capital Region Physicians - The Sloan Clinic 1505 Southwest Blvd Jefferson City MO 65109-2431 Ph: (573) 632-5544 |
| NPI Number | 1447405568 |
|---|---|
| Provider Enumeration Date | 11/18/2008 |
| Last Update Date | 04/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447405568 | NPI | - | NPPES |
| 249990557 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | 108684 (Missouri) | Primary |
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