# HANNIBAL CLINIC OPERATIONS, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hannibal Clinic @ Bowling Green
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215916911
- **Authorized official:** MR. MICHAEL J BUKSTEIN MD (PHYSICIAN EXEC. DIRECTOR)
- **Authorized official phone:** (573) 231-3172

## Contact information

- **Practice address:** 710 BUSINESS HIGHWAY 61 SOUTH, BOWLING GREEN, MO 63334-5239
- **Practice address phone:** (573) 324-2063
- **Practice address fax:** (573) 324-2167
- **Mailing address:** 100 MEDICAL DR, P.O. BOX 311, HANNIBAL, MO 63401-6877
- **Mailing address phone:** (573) 221-5250
- **Mailing address fax:** (573) 231-3706

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/11/2006
- **Last updated:** 04/18/2022