# KIRKSVILLE MISSOURI HOSPITAL COMPANY LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KIRKSVILLE MISSOURI HOSPITAL COMPANY LLC
- **Other names:** Northeast Regional Medical Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1336491448
- **Legal business name:** KIRKSVILLE MISSOURI HOSPITAL COMPANY LLC
- **Authorized official:** BRIAN PEOPLES (VICE-PRESIDENT)
- **Authorized official phone:** (615) 465-7585

## Contact information

- **Practice address:** 1607 S BALTIMORE ST, KIRKSVILLE, MO 63501-4536
- **Practice address phone:** (660) 627-3363
- **Practice address fax:** (660) 627-3367
- **Mailing address:** PO BOX 689022, FRANKLIN, TN 37068-9022
- **Mailing address phone:** (615) 465-7000
- **Mailing address fax:** (615) 465-3007

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | MO | Yes |
| 207R00000X | Internal Medicine Physician | — | MO | — |
| 207RC0000X | Cardiovascular Disease Physician | — | MO | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 10/12/2012
- **Last updated:** 12/04/2012