Organization
CENTRAL FAMILY MEDICINE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE LINN BOLING (PRACTICE MANAGER)
(660) 747-5114
Entity
Organization
Contact information
Practice address
407 E RUSSELL AVE BLDG C, WARRENSBURG, MO 64093-1242
(660) 747-5114
(660) 747-5684
Mailing address
407 E RUSSELL AVE BLDG C, WARRENSBURG, MO 64093-1242
(660) 747-5114
(660) 747-5684
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35935011
BLUE CROSS BLUE SHIELD KC
MO
Enumeration date
07/18/2006
Last updated
08/22/2020
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