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Organization

SAINT LUKES HOSPITAL OF TRENTON

Active
Parent organization
SAINT LUKES HOSPITAL OF TRENTON
Other names
Wright Memorial Jamesport Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
SAINT LUKES HOSPITAL OF TRENTON
Authorized official
GARY W JORDAN (CEO)
(660) 358-5700
Entity
Organization

Contact information

Practice address
301 W 2ND ST, JAMESPORT, MO 64648-8208
(660) 684-6244
(660) 684-6246
Mailing address
189 IOWA BLVD, TRENTON, MO 64683-8343
(660) 358-5750
(660) 358-5740

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
DOR9350
MO
363LF0000X
Family Nurse Practitioner
99778
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
508190006
MO
Enumeration date
08/16/2006
Last updated
05/14/2014
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