Organization
JEFFERSON CITY MEDICAL GROUP, P.C.
Active
Organization
JEFFERSON CITY MEDICAL GROUP, P.C.
Active
Other names
Jefferson City Orthopaedics
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
1225 W. STADIUM BLVD, JEFFERSON CITY, MO 65109
(573) 635-8000
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
506225507
—
MO
01
—
CD6058
MEDICARE RAILROAD
MO
Enumeration date
12/26/2006
Last updated
12/26/2018
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