Organization
PHYSICIAN GROUPS, LC
Active
Other names
Mediquick North-Moberly
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KNOCKE (PRESIDENT)
(314) 996-7690
Entity
Organization
Contact information
Practice address
1600 N MORLEY ST, SUITE A120, MOBERLY, MO 65270-3666
(660) 263-1225
(660) 263-1613
Mailing address
670 MASON RIDGE CENTER DR, SUITE 300, SAINT LOUIS, MO 63141-8573
(314) 996-7644
(314) 996-7658
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
11/28/2006
Last updated
12/02/2009
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