Organization
DO NOT USE
Active
Other names
Do Not Use
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL G BURCHAM SR. (CEO)
(573) 727-9080
Entity
Organization
Contact information
Practice address
217 PHYSICIANS PARK DR, POPLAR BLUFF, MO 63901-3956
(573) 727-9080
Mailing address
217 PHYSICIANS PARK DR, POPLAR BLUFF, MO 63901
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
—
—
Other
Enumeration date
01/25/2013
Last updated
02/14/2013
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