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Organization
CAPITAL REGION MEDICAL CENTER
Active
Organization
CAPITAL REGION MEDICAL CENTER
Active
Other names
Capital Region Physicians - Obstetrics & Gynecology
Organization subpart
No
Provider details
NPI number
Authorized official
TOM LUEBBERING (VP OF FINANCE)
(573) 632-5100
Entity
Organization
Contact information
Practice address
1014 MADISON ST, JEFFERSON CITY, MO 65101-3458
(573) 632-5510
(573) 632-5810
Mailing address
PO BOX 1128, JEFFERSON CITY, MO 65102-1128
(573) 632-5510
(573) 632-5810
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/05/2006
Last updated
08/21/2014
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