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Organization

CAPITAL REGION MEDICAL CENTER

Active
Other names
Capital Region Physicians - Miller Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
TOM LUEBBERING (VICE PRESIDENT OF FINANCE)
(573) 632-5100
Entity
Organization

Contact information

Practice address
1705 CHRISTY DR, SUITE 201, JEFFERSON CITY, MO 65101-5195
(573) 635-0621
(573) 635-3534
Mailing address
1705 CHRISTY DR, SUITE 201, JEFFERSON CITY, MO 65101-5195
(573) 635-0621
(573) 635-3534

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
12/06/2013
Last updated
12/06/2013
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