# WELLPOINTE FAMILY MEDICAL

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

## Provider details

- **NPI number:** 1720073638
- **Authorized official:** WARD M LAWSON PHD (PHD PRESIDENT)
- **Authorized official phone:** (417) 859-7746

## Contact information

- **Practice address:** 543 W HUBBLE DR, MARSHFIELD, MO 65706-1532
- **Practice address phone:** (417) 859-7746
- **Practice address fax:** (417) 859-7411
- **Mailing address:** PO BOX 817, CAPE GIRARDEAU, MO 63702-0817
- **Mailing address phone:** (573) 335-4715
- **Mailing address fax:** (573) 334-2303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/16/2005
- **Last updated:** 02/26/2009