Organization
KIRKSVILLE CLINIC CORP
Active
Parent organization
KIRKSVILLE CLINIC CORP
Organization subpart
Yes
Provider details
NPI number
Legal business name
KIRKSVILLE CLINIC CORP
Authorized official
BRIAN A PEOPLES (VICE PRESIDENT)
(615) 465-7585
Entity
Organization
Contact information
Practice address
1607 S BALTIMORE ST, KIRKSVILLE, MO 63501-4536
(660) 627-3363
(660) 785-1927
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-8575
(615) 465-3007
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
208M00000X
Hospitalist Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538155817
—
IA
01
—
191271
BCBS
MO
05
—
507437101
—
MO
Enumeration date
09/22/2005
Last updated
06/27/2012
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