# POPLAR BLUFF MEDICAL PARTNERS, LLC

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

## Provider details

- **NPI number:** 1407845472
- **Authorized official:** MR. MICHAEL BURCHAM MBA (PRESIDENT, CEO)
- **Authorized official phone:** (573) 727-9080

## Contact information

- **Practice address:** 221 PHYSICIANS PARK, POPLAR BLUFF, MO 63901-3956
- **Practice address phone:** (573) 727-9080
- **Practice address fax:** (573) 686-1245
- **Mailing address:** 221 PHYSICIANS PARK, POPLAR BLUFF, MO 63901-3956
- **Mailing address phone:** (573) 727-9080
- **Mailing address fax:** (573) 686-1245

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | NOT REQUIRED | MO | — |
| 261QR0200X | Radiology Clinic/Center | NOT REQUIRED | MO | Yes |
| 261QR0206X | Mammography Clinic/Center | NOT REQUIRED | MO | — |

## Other

- **Enumeration date:** 10/20/2005
- **Last updated:** 05/27/2008