# BOONE PHYSICIAN SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Boone Health Primary Care - Boonville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558108837
- **Authorized official:** JARED LONG (ADMINISTRATOR)
- **Authorized official phone:** (573) 815-6245

## Contact information

- **Practice address:** 606 E SPRING ST, BOONVILLE, MO 65233-1523
- **Practice address phone:** (660) 882-3955
- **Practice address fax:** (660) 882-3972
- **Mailing address:** 606 E SPRING ST, BOONVILLE, MO 65233-1523
- **Mailing address phone:** (660) 882-3955
- **Mailing address fax:** (660) 882-3972

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/12/2024
- **Last updated:** 07/12/2024