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Individual

DR. LINDA S JABBARI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1930 N BUSINESS ROUTE 5, UNIT 1A, CAMDENTON, MO 65020-2659
(573) 346-5624
(573) 346-1957
Mailing address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1873
IA
207Q00000X
Family Medicine Physician
Primary
2007035506
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0186296
IA
01
18629
BC/BS
IA
05
242567105
MO
01
P00625555
RAILROAD MEDICARE
MO
Enumeration date
01/20/2006
Last updated
07/22/2009
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