| Ssm Health Medical Group - Family Medicine | |
|
626 E Summit St Ste L Mexico MO 65265-3298 | |
| (573) 581-6266 | |
| (573) 581-0955 |
| Full Name | Ssm Health Medical Group - Family Medicine |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 626 E Summit St Ste L, Mexico, Missouri |
| Authorized Official Name and Position | Robert V. Vanconia (PRESIDENT/CEO) |
| Authorized Official Contact | 5735828108 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ssm Health Medical Group - Family Medicine 626 E Summit St Ste L Mexico MO 65265-3298 Ph: (573) 581-6266 | Ssm Health Medical Group - Family Medicine 626 E Summit St Ste L Mexico MO 65265-3298 Ph: (573) 581-6266 |
| NPI Number | 1467462010 |
|---|---|
| Provider Enumeration Date | 08/08/2006 |
| Last Update Date | 05/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467462010 | NPI | - | NPPES |
| 597765809 | Medicaid | MO | |
| 507765808 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
News Archive
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