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Organization
CAPITAL REGION MEDICAL CENTER
Active
Organization
CAPITAL REGION MEDICAL CENTER
Active
Other names
Capital Region Physicians - Linn
Organization subpart
No
Provider details
NPI number
Authorized official
TOM LUEBBERING (VP OF FINANCE)
(573) 632-5100
Entity
Organization
Contact information
Practice address
916 E MAIN ST, LINN, MO 65051-9780
(573) 897-2525
(573) 897-3566
Mailing address
916 E MAIN ST, LINN, MO 65051-9780
(573) 897-2525
(573) 897-3566
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50737368
—
MO
01
—
DD9083
RR MEDICARE
MO
Enumeration date
02/03/2006
Last updated
08/23/2013
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