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Organization
CARUTHERSVILLE CLINIC
Active
Organization
CARUTHERSVILLE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY D LEDBETTER (DIRECTOR OF OPERATIONS)
(573) 651-4488
Entity
Organization
Contact information
Practice address
412 WARD AVE, CARUTHERSVILLE, MO 63830-1451
(579) 333-0033
(573) 333-2522
Mailing address
PO BOX 881, CARUTHERSVILLE, MO 63830-0881
(579) 333-0033
(573) 333-2522
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
—
507402907
—
MO
Enumeration date
04/23/2008
Last updated
04/23/2008
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