Organization
NORTHEAST MISSOURI HEALTH COUNCIL INC
Active
Other names
Northeast Missouri Pediatric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW H. GRIMM (EXECUTIVE DIRECTOR)
(660) 627-5757
Entity
Organization
Contact information
Practice address
600 W. JEFFERSON, KIRKSVILLE, MO 63501-2819
(660) 627-2229
(660) 627-2233
Mailing address
314 E MCPHERSON ST, KIRKSVILLE, MO 63501-3557
(660) 627-5757
(660) 627-5802
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2005037590
MO
208000000X
Pediatrics Physician
2006022612
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
503351801
—
MO
Enumeration date
01/29/2007
Last updated
04/01/2009
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