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Organization
HANNIBAL CLINIC OPERATIONS, L.L.C.
Active
Organization
HANNIBAL CLINIC OPERATIONS, L.L.C.
Active
Other names
Hannibal Clinic @ Bowling Green
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J BUKSTEIN MD (PHYSICIAN EXEC. DIRECTOR)
(573) 231-3172
Entity
Organization
Contact information
Practice address
710 BUSINESS HIGHWAY 61 SOUTH, BOWLING GREEN, MO 63334-5239
(573) 324-2063
(573) 324-2167
Mailing address
100 MEDICAL DR, P.O. BOX 311, HANNIBAL, MO 63401-6877
(573) 221-5250
(573) 231-3706
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/11/2006
Last updated
04/18/2022
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