Organization
FARMINGTON CLINIC COMPANY LLC
Active
Parent organization
FARMINGTON CLINIC COMPANY LLC
Other names
Mineral Area Orthopedics
Organization subpart
Yes
Provider details
NPI number
Legal business name
FARMINGTON CLINIC COMPANY LLC
Authorized official
JEAN M CALLAHAN (PROVIDER ENROLLMENT)
(573) 701-7346
Entity
Organization
Contact information
Practice address
POST OFFICE BOX 504354, ST. LOUIS, ST. LOUIS, MO 63150-0001
(573) 756-2600
(573) 756-2615
Mailing address
1101 WEBER ROAD, SUITE 203, FARMINGTON, MO 63640-3325
(573) 756-2600
(573) 756-2615
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
09/24/2007
Last updated
12/28/2009
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