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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