Organization
HANNIBAL CLINIC OPERATIONS, L.L.C.
Active
Other names
Hannibal Clinic @ Monroe City
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J BUKSTEIN MD (PHYSICIAN EXEC DIRECTOR)
(573) 231-3172
Entity
Organization
Contact information
Practice address
400 N MAIN ST, MONROE CITY, MO 63456-1318
(573) 735-4541
(573) 735-2143
Mailing address
100 MEDICAL DR, HANNIBAL, MO 63401-6877
(573) 221-5250
(573) 231-3824
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000013771
PTAN
MO
Enumeration date
01/11/2006
Last updated
04/18/2022
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