| Hannibal Clinic @ Bowling Green | |
|
710 Business Highway 61 South Bowling Green MO 63334-5239 | |
| (573) 324-2063 | |
| (573) 324-2167 |
| Full Name | Hannibal Clinic @ Bowling Green |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 710 Business Highway 61 South, Bowling Green, Missouri |
| Authorized Official Name and Position | Michael J Bukstein (PHYSICIAN EXEC. DIRECTOR) |
| Authorized Official Contact | 5732313172 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hannibal Clinic @ Bowling Green 100 Medical Dr P.o. Box 311 Hannibal MO 63401-6877 Ph: (573) 221-5250 | Hannibal Clinic @ Bowling Green 710 Business Highway 61 South Bowling Green MO 63334-5239 Ph: (573) 324-2063 |
| NPI Number | 1215916911 |
|---|---|
| Provider Enumeration Date | 01/11/2006 |
| Last Update Date | 04/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215916911 | NPI | - | NPPES |
| 500221007 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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