Organization
COMMUNITY HOSPITAL ASSOCIATION
Active
Other names
Tarkio Family Medicine, Community Hospital-Fairfax
Organization subpart
No
Provider details
NPI number
Authorized official
JON P DAVIS (CFO)
(660) 686-2320
Entity
Organization
Contact information
Practice address
102 S 6TH ST, TARKIO, MO 64491-1513
(660) 736-4193
(660) 736-4966
Mailing address
102 S 6TH STREET, TARKIO, MO 64491-1513
(660) 736-4193
(660) 736-4966
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
MO
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27443017
BCBS KANSAS CITY MO
MO
05
—
505180802
—
MO
Enumeration date
06/10/2005
Last updated
10/21/2019
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