Organization
POTOSI EMERGENCY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISHA C FALK (VP OF CONTRACTING)
(337) 609-1221
Entity
Organization
Contact information
Practice address
300 HEALTH WAY DR, POTOSI, MO 63664-1420
(800) 893-9698
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
MO
208M00000X
Hospitalist Physician
—
—
363A00000X
Physician Assistant
—
MO
363L00000X
Nurse Practitioner
—
MO
Other
Enumeration date
06/10/2015
Last updated
12/12/2022
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