Organization
JEFFERSON CITY MEDICAL GROUP, P.C.
Active
Other names
Ear, Nose, Throat and Sinus Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY LEE PATRICK M.D. (PRESIDENT)
(573) 635-5264
Entity
Organization
Contact information
Practice address
1241 W STADIUM BLVD, SUITE 1000, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507560209
—
MO
Enumeration date
12/27/2006
Last updated
12/26/2018
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