Organization
SSM AUDRAIN HEALTH CARE, INC.
Active
Parent organization
SSM AUDRAIN HEALTH CARE, INC.
Other names
SSM Health Medical Group - Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM AUDRAIN HEALTH CARE, INC.
Authorized official
ROBERT B. VANCONIA (PRESIDENT/CEO)
(573) 582-8108
Entity
Organization
Contact information
Practice address
221 N MAIN ST, PARIS, MO 65275-1328
(660) 327-4000
(660) 327-4007
Mailing address
221 N MAIN ST, PARIS, MO 65275-1328
(660) 327-4000
(660) 327-4007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548520026
—
MO
Enumeration date
05/18/2012
Last updated
05/08/2015
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