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Organization

CAPITAL REGION MEDICAL CENTER

Active
Other names
Capital Region Physicians - Capital Family Care
Organization subpart
No

Provider details

NPI number
Authorized official
TOM LUEBBERING (VP OF FINANCE)
(573) 632-5100
Entity
Organization

Contact information

Practice address
1500 SOUTHWEST BLVD, SUITE B, JEFFERSON CITY, MO 65109-2472
(573) 635-6350
(573) 635-9049
Mailing address
1500 SOUTHWEST BLVD, SUITE B, JEFFERSON CITY, MO 65109-2472
(573) 635-6350
(573) 635-9049

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
206009703
MO
Enumeration date
01/08/2007
Last updated
08/23/2013
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