Organization
JACKSON PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN L MAYBERRY (OFFICE MANAGER)
(573) 204-1400
Entity
Organization
Contact information
Practice address
2685 E MAIN ST STE A, JACKSON, MO 63755-2474
(573) 204-1400
(573) 204-1480
Mailing address
2685 E MAIN ST STE A, JACKSON, MO 63755-2474
(573) 204-1400
(573) 204-1480
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
106442
MO
Other
Enumeration date
05/23/2017
Last updated
05/25/2017
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