Organization
DOROTHY M. MUNCH, D.O., LLC
Active
Other names
Poplar Bluff Wellness Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAULA J MCALISTER BSHA/LTC (ADMINISTRATOR)
(573) 778-1697
Entity
Organization
Contact information
Practice address
930 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-4242
(573) 778-1620
(573) 778-1486
Mailing address
930 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-4242
(573) 778-1620
(573) 778-1486
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36720
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000E14668
PREMIER BENEFITS
MO
01
—
164653
BLUE CROSS BLUE SHIELD
MO
01
—
1922003276
INDIVIDUAL NPI
MO
05
—
242613073
—
MO
05
—
242613084
—
MO
01
—
26D1003101
CLIA
MO
01
—
915331
UNITED HEALTH CARE
—
01
—
P00109903
MEDICARE RAILROAD
MO
Enumeration date
09/09/2008
Last updated
09/09/2008
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