Organization
JESSE DWAYNE HELTON
Active
Other names
Byrnes Mill Medical Center-Richwoods
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE DWAYNE HELTON DO (OWNER)
(573) 678-2444
Entity
Organization
Contact information
Practice address
10649 STATE HIGHWAY A, RICHWOODS, MO 63071-2558
(573) 678-2444
(573) 678-2445
Mailing address
10649 STATE HIGHWAY A, PO BOX 280, RICHWOODS, MO 63071-2558
(573) 678-2444
(573) 678-2445
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2006025334
MO
207Q00000X
Family Medicine Physician
R6F69
MO
207R00000X
Internal Medicine Physician
DO113093
MO
261QR1300X
Rural Health Clinic/Center
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26D1024953
CLIA
MO
05
—
506296607
—
MO
05
—
595379314
—
MO
Enumeration date
02/16/2006
Last updated
08/14/2008
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