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Organization

PREMIER FAMILY PHYSICIANS, LC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNNETH DEAN PHILLIPS MD (OWNER/PHYSICIAN)
(573) 651-1333
Entity
Organization

Contact information

Practice address
8 DOCTORS PARK, CAPE GIRARDEAU, MO 63703-4928
(573) 651-1333
(573) 651-1324
Mailing address
8 DOCTORS PARK, CAPE GIRARDEAU, MO 63703-4928
(573) 651-1333
(573) 651-1324

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
508145604
MO
Enumeration date
01/31/2006
Last updated
07/21/2022
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