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Organization
SAINT FRANCIS MEDICAL CENTER
Active
Organization
SAINT FRANCIS MEDICAL CENTER
Active
Other names
Saint Francis Clinic Poplar Bluff Northwest Medical
Organization subpart
No
Provider details
NPI number
Authorized official
KIM GILLILAND (CREDENTIALING)
(573) 331-5583
Entity
Organization
Contact information
Practice address
2210 BARRON RD STE 120, POPLAR BLUFF, MO 63901-1908
(573) 785-2005
(573) 785-9444
Mailing address
PO BOX 801143, KANSAS CITY, MO 64180-1143
(573) 331-5583
(573) 331-5079
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
261Q00000X
Clinic/Center
Primary
—
NULL
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/12/2019
Last updated
09/17/2021
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