# MARBLE HILL MEDICAL CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588184774
- **Authorized official:** SUZANNE MATTHEWS (NURSE PRACTITIONER)
- **Authorized official phone:** (573) 238-0038

## Contact information

- **Practice address:** 307 BROADWAY ST, MARBLE HILL, MO 63764-8321
- **Practice address phone:** (573) 238-0038
- **Practice address fax:** (573) 238-0042
- **Mailing address:** 307 BROADWAY ST, MARBLE HILL, MO 63764-8321
- **Mailing address phone:** (573) 238-0038
- **Mailing address fax:** (573) 238-0042

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/20/2017
- **Last updated:** 07/21/2022