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Organization
CAPITAL REGION MEDICAL CENTER
Active
Organization
CAPITAL REGION MEDICAL CENTER
Active
Other names
Capital Region Physicians - Primary Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TOM LUEBBERING (VP OF FINANCE)
(573) 632-5100
Entity
Organization
Contact information
Practice address
3308 W EDGEWOOD, SUITE B, JEFFERSON CITY, MO 65109
(573) 644-6999
(573) 644-7880
Mailing address
PO BOX 1128, JEFFERSON CITY, MO 65102-1128
(573) 644-6999
(573) 644-7880
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/23/2009
Last updated
08/21/2014
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