# KNEIBERT CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104804699
- **Authorized official:** ROBERT E CHRISTIAN (ADMINISTRATOR)
- **Authorized official phone:** (573) 778-7210

## Contact information

- **Practice address:** 686 LESTER ST, POPLAR BLUFF, MO 63901
- **Practice address phone:** (573) 686-2411
- **Practice address fax:** (573) 686-8452
- **Mailing address:** PO BOX 220, POPLAR BLUFF, MO 63902
- **Mailing address phone:** (573) 686-2411
- **Mailing address fax:** (573) 686-8452

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/04/2006
- **Last updated:** 03/22/2012