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Organization

JEFFERSON CITY MEDICAL GROUP, P.C.

Active
Other names
Thomas J. Folz, M.D.
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
1225 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 556-7725
(573) 761-3596
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000015437
MEDICARE
MO
01
CD6060
MEDICARE RAILROAD
MO
Enumeration date
12/27/2006
Last updated
12/26/2018
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