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Organization
CAPITAL REGION MEDICAL CENTER
Active
Organization
CAPITAL REGION MEDICAL CENTER
Active
Other names
Capital Region Physicians - Versailles
Organization subpart
No
Provider details
NPI number
Authorized official
TOM LUEBBERING (VP OF FINANCE)
(573) 632-5100
Entity
Organization
Contact information
Practice address
901 KIDWELL DR, VERSAILLES, MO 65084-1784
(573) 378-4666
(573) 378-5099
Mailing address
901 KIDWELL DR, VERSAILLES, MO 65084-1784
(573) 378-4666
(573) 378-5099
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500383609
—
MO
Enumeration date
12/28/2005
Last updated
08/23/2013
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