Organization
JEFFERSON CITY MEDICAL GROUP, P.C.
Active
Organization
JEFFERSON CITY MEDICAL GROUP, P.C.
Active
Other names
John J. Krautmann
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL CRAIGHEAD M.D. (COO)
(573) 556-7776
Entity
Organization
Contact information
Practice address
1241 W STADIUM BLVD, LOWER LEVEL, SUITE 400A, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD6060
MEDICARE RAILROAD
MO
Enumeration date
12/27/2006
Last updated
01/14/2008
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