Organization
JEFFERSON CITY MEDICAL GROUP, P.C.
Active
Other names
Express Care- Elm Court
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY PATRICK M.D. (PRESIDENT)
(573) 635-5264
Entity
Organization
Contact information
Practice address
1735 ELM CT, JEFFERSON CITY, MO 65101-4129
(573) 634-4878
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 635-5246
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0428190006
DMERC/NORDIAN
MO
05
—
506292002
—
MO
01
—
CC7852
MEDICARE RAILROAD
MO
Enumeration date
10/07/2024
Last updated
10/07/2024
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