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Organization

HOMETOWN MEDICAL GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LESLIE ALEXANDER (CREDENTIALING SPECIALIST)
(301) 661-3481
Entity
Organization

Contact information

Practice address
2195 N CITATION AVE, SPRINGFIELD, MO 65802-5420
(417) 476-6033
(417) 429-4543
Mailing address
2195 N CITATION AVE, SPRINGFIELD, MO 65802-5420
(417) 476-6033
(417) 429-4543

Taxonomy

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

Other

Enumeration date
01/31/2022
Last updated
01/31/2022
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