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Organization
SSM AUDRAIN HEALTH CARE, INC.
Active
Organization
SSM AUDRAIN HEALTH CARE, INC.
Active
Parent organization
SSM AUDRAIN HEALTH CARE. INC.
Other names
SSM Health Medical Group - Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM AUDRAIN HEALTH CARE. INC.
Authorized official
MR. ROBERT V. VANCONIA (PRESIDENT/CEO)
(573) 582-8108
Entity
Organization
Contact information
Practice address
626 E SUMMIT ST STE L, MEXICO, MO 65265-3298
(573) 581-6266
(573) 581-0955
Mailing address
626 E SUMMIT ST STE L, MEXICO, MO 65265-3298
(573) 581-6266
(573) 581-0955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/08/2006
Last updated
05/08/2015
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