Organization
SSM AUDRAIN HEALTH CARE, INC.
Active
Other names
SSM Health Medical Group- Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES T STRATTON (REGIONAL CFO)
(573) 681-3129
Entity
Organization
Contact information
Practice address
3626 S CLARK ST, SUITE A, MEXICO, MO 65265-4104
(573) 581-7366
(573) 581-7422
Mailing address
1001 SOUTHWEST BLVD STE A, JEFFERSON CITY, MO 65109-2501
(573) 681-3000
(573) 761-6947
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/24/2007
Last updated
09/17/2018
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