Organization
JESSE D HELTON
Active
Other names
Byrnes Mill Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE DWAYNE HELTON DO (OWNER)
(636) 677-9977
Entity
Organization
Contact information
Practice address
100 OSAGE EXECUTIVE CIR, HOUSE SPRINGS, MO 63051-1382
(636) 677-9977
(636) 677-9179
Mailing address
100 OSAGE EXECUTIVE CIR, HOUSE SPRINGS, MO 63051-1382
(636) 677-9977
(636) 677-9179
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2006025334
MO
207Q00000X
Family Medicine Physician
R6F69
MO
207R00000X
Internal Medicine Physician
DO113093
MO
261QR1300X
Rural Health Clinic/Center
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26D0975596
CLIA
MO
05
—
504043001
—
MO
05
—
595379306
—
MO
Enumeration date
02/16/2006
Last updated
08/14/2008
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