Organization
FOREST CITY FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY KLEFFNER (BUSINESS OFFICE)
(573) 265-8840
Entity
Organization
Contact information
Practice address
1000 N JEFFERSON ST, SAINT JAMES, MO 65559-1078
(573) 265-8840
(573) 265-8884
Mailing address
1000 N JEFFERSON ST, SAINT JAMES, MO 65559-1078
(573) 265-8840
(573) 265-8884
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505749309
—
MO
Enumeration date
12/12/2006
Last updated
02/28/2011
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