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Organization

BIG TREE MEDICAL GROUP LLC

Active
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Organization

BIG TREE MEDICAL GROUP LLC

Active
Other names
Big Tree Medical Home
Organization subpart
No

Provider details

NPI number
Authorized official
ADAM WHEELER MD (CEO)
(573) 673-5770
Entity
Organization

Contact information

Practice address
200 CORPORATE LAKE DR, COLUMBIA, MO 65203-7172
(573) 814-1170
Mailing address
200 CORPORATE LAKE DR, COLUMBIA, MO 65203-7172
(573) 814-1170

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
NULL
103K00000X
Behavior Analyst
—
—
207K00000X
Allergy & Immunology Physician
—
NULL
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL

Other

Enumeration date
06/17/2021
Last updated
01/04/2023
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