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Individual

DR. LORETTA J. FEELER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
(573) 634-7423
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 635-5264
(573) 634-7423

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R8604
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080107337
RAILROAD MEDICARE
MO
01
23968
BCBS
MO
05
240009712
MO
01
CD6060
RR GROUP
MO
Enumeration date
12/22/2005
Last updated
07/31/2008
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