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Organization

CAPITAL CITY MEDICAL ASSOCIATES, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RACHEL J KEMPKER (DATA PROCESSING MANAGER)
(573) 634-2620
Entity
Organization

Contact information

Practice address
1505 SOUTHWEST BLVD, JEFFERSON CITY, MO 65109-2431
(573) 634-2620
(573) 761-1863
Mailing address
1505 SOUTHWEST BLVD, JEFFERSON CITY, MO 65109-2431
(573) 634-2620
(573) 761-1863

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MO
207RC0000X
Cardiovascular Disease Physician
MO
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
MO
207RG0100X
Gastroenterology Physician
MO
207RN0300X
Nephrology Physician
MO
207RP1001X
Pulmonary Disease Physician
MO
207RR0500X
Rheumatology Physician
MO
207RS0012X
Sleep Medicine (Internal Medicine) Physician
111467
MO
208600000X
Surgery Physician
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CD3561
RAILROAD MEDICARE
MO
Enumeration date
05/12/2006
Last updated
01/08/2008
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