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Organization
POPLAR BLUFF MEDICAL PARTNERS, LLC
Active
Organization
POPLAR BLUFF MEDICAL PARTNERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BURCHAM MBA (PRESIDENT, CEO)
(573) 727-9080
Entity
Organization
Contact information
Practice address
221 PHYSICIANS PARK, POPLAR BLUFF, MO 63901-3956
(573) 727-9080
(573) 686-1245
Mailing address
221 PHYSICIANS PARK, POPLAR BLUFF, MO 63901-3956
(573) 727-9080
(573) 686-1245
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
NOT REQUIRED
MO
261QR0200X
Radiology Clinic/Center
Primary
NOT REQUIRED
MO
261QR0206X
Mammography Clinic/Center
NOT REQUIRED
MO
Other
Enumeration date
10/20/2005
Last updated
05/27/2008
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