Organization
JEFFERSON CITY MEDICAL GROUP, P.C.
Active
Other names
Family Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY LEE PATRICK M.D. (PRESIDENT)
(573) 635-5264
Entity
Organization
Contact information
Practice address
1306 E MAIN ST, LINN, MO 65051-2503
(573) 897-2202
(573) 897-3157
Mailing address
1306 E MAIN ST, LINN, MO 65051-2503
(573) 897-2202
(573) 897-3157
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC7852
MEDICARE RAILROAD
MO
01
—
CD6058
MEDICARE RAILROAD
MO
01
—
CD6061
MEDICARE RAILROAD
MO
Enumeration date
05/28/2006
Last updated
12/26/2018
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