Organization
ELITE OBSTETRICS AND GYNECOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY GIBBS (MANAGING DIRECTOR)
(636) 751-5598
Entity
Organization
Contact information
Practice address
225 PHYSICIANS PARK STE 305, POPLAR BLUFF, MO 63901-3935
(573) 772-4340
Mailing address
PO BOX 334, VAN BUREN, MO 63965-0334
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
04/24/2024
Last updated
05/06/2024
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