# CIRCLE MAKER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Center for Diagnostic Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962134114
- **Authorized official:** DR. LISA LYNN PARKER MD (PHYSICIAN)
- **Authorized official phone:** (417) 461-3009

## Contact information

- **Practice address:** 320 W MOUNT VERNON BLVD, MOUNT VERNON, MO 65712-1940
- **Practice address phone:** (417) 461-0056
- **Practice address fax:** (833) 707-1944
- **Mailing address:** 320 W MOUNT VERNON BLVD, MOUNT VERNON, MO 65712-1940
- **Mailing address phone:** (417) 461-0056

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/27/2022
- **Last updated:** 03/11/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 205890106 | — | MO |