Organization
EASTERN MISSOURI GENERAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RIOHARD MARTIN SECOR JR. DO (PRESIDENT PHYSICIAN)
(573) 431-4510
Entity
Organization
Contact information
Practice address
322 NO STATE STREET, DESLOGE, MO 63601-3052
(573) 431-4510
(573) 431-4790
Mailing address
322 NO STATE STREET, DESLOGE, MO 63601-3052
(573) 431-4510
(573) 431-4790
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10179
MS
207Q00000X
Family Medicine Physician
Primary
R9A44
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0130013
UNITED HEALTH CARE
—
01
—
04232001
AETNA
MO
01
—
101430
HL HEALTHLINK
MO
01
—
103
GHP GROUP HEALTH PLAN
—
01
—
25000
BCBS
MO
01
—
4384846
AETNA
—
Enumeration date
12/28/2006
Last updated
08/22/2020
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