Organization
SAINT FRANCIS MEDICAL CENTER
Active
Other names
Saint Francis Clinic Poplar Bluff Northwest Medical
Organization subpart
No
Provider details
NPI number
Authorized official
KIM GILLILAND (CREDENTIALING)
(573) 331-5583
Entity
Organization
Contact information
Practice address
2210 BARRON RD STE 120, POPLAR BLUFF, MO 63901-1908
(573) 785-2005
(573) 785-9444
Mailing address
PO BOX 801143, KANSAS CITY, MO 64180-1143
(573) 331-5583
(573) 331-5079
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/12/2019
Last updated
09/17/2021
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