Organization
CAPITAL REGION MEDICAL CENTER
Active
Other names
Capital Region Medical Clinic-Stover
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES R MCMILLAN (VP FINANCE)
(573) 632-5100
Entity
Organization
Contact information
Practice address
2ND STREET AND OAK, STOVER, MO 65078
(573) 377-2313
(573) 377-4243
Mailing address
PO BOX 489, STOVER, MO 65078
(573) 377-2313
(573) 377-4243
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007100
RR MEDICARE
MO
Enumeration date
03/17/2006
Last updated
12/12/2007
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