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Organization
EASTERN MISSOURI GENERAL SERVICES INC
Active
Organization
EASTERN MISSOURI GENERAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RIOHARD MARTIN SECOR JR. DO (PRESIDENT PHYSICIAN)
(573) 431-4510
Entity
Organization
Contact information
Practice address
322 NO STATE STREET, DESLOGE, MO 63601-3052
(573) 431-4510
(573) 431-4790
Mailing address
322 NO STATE STREET, DESLOGE, MO 63601-3052
(573) 431-4510
(573) 431-4790
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10179
MS
207Q00000X
Family Medicine Physician
Primary
R9A44
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0130013
UNITED HEALTH CARE
—
01
—
04232001
AETNA
MO
01
—
101430
HL HEALTHLINK
MO
01
—
103
GHP GROUP HEALTH PLAN
—
01
—
25000
BCBS
MO
01
—
4384846
AETNA
—
Enumeration date
12/28/2006
Last updated
08/22/2020
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