Organization
CAPITAL REGION MEDICAL CENTER
Active
Other names
Capital Region Physicians - California
Organization subpart
No
Provider details
NPI number
Authorized official
TOM LUEBBERING (VP OF FINANCE)
(573) 632-5100
Entity
Organization
Contact information
Practice address
704 BUCHANAN HWY SW, CALIFORNIA, MO 65018
(573) 796-3111
(573) 796-3042
Mailing address
704 BUCHANAN HWY SW, CALIFORNIA, MO 65018
(573) 796-3111
(573) 796-3042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507984300
—
MO
01
—
CK5622
RR MEDICARE
MO
Enumeration date
02/02/2006
Last updated
08/23/2013
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