# PUTNAM COUNTY MEDICAL HOME CLINICS, LLC

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

## Provider details

- **NPI number:** 1437600657
- **Authorized official:** DAWN FAIRLEY (SOLE OWNER)
- **Authorized official phone:** (610) 737-4704

## Contact information

- **Practice address:** 103 S 18TH ST, UNIONVILLE, MO 63565-1642
- **Practice address phone:** (660) 947-2300
- **Practice address fax:** (660) 947-2307
- **Mailing address:** 2221 GREEN ST, UNIONVILLE, MO 63565-1426
- **Mailing address phone:** (610) 737-4704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/24/2016
- **Last updated:** 10/24/2016