# FAMILY HEALTHCARE OF AUXVASSE PC

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

## Provider details

- **NPI number:** 1134308026
- **Authorized official:** REBECCA B KELLEY MD (PRESIDENT OWNER)
- **Authorized official phone:** (573) 386-5959

## Contact information

- **Practice address:** 201 S MAIN ST, AUXVASSE, MO 65231
- **Practice address phone:** (573) 386-5959
- **Practice address fax:** (573) 386-5995
- **Mailing address:** PO BOX 190, AUXVASSE, MO 65231-0190
- **Mailing address phone:** (573) 386-5959
- **Mailing address fax:** (573) 386-5995

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 106418 | MO | Yes |

## Other

- **Enumeration date:** 10/29/2007
- **Last updated:** 11/19/2007