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Organization

FLAT CREEK ENTERPRISES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVE D WEEMS D.O. (OWNER)
(417) 773-0520
Entity
Organization

Contact information

Practice address
1410 E KEARNEY ST, SUITE D, SPRINGFIELD, MO 65803-4102
(417) 773-0520
Mailing address
PO BOX 8235, SPRINGFIELD, MO 65801-8235
(417) 864-5455
(417) 864-5781

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
114747
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
505488601
MO
01
DG9102
RAILROAD MEDICARE
MO
Enumeration date
12/06/2007
Last updated
04/29/2008
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