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NPI Profile for CAPITAL REGION RESIDENT CLINIC in JEFFERSON CITY, MO.
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] |
| NPI # | 1649514050 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 11/26/2012 | |
| Last updated | 06/10/2014 - About 12 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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CAPITAL REGION RESIDENT CLINIC
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CAPITAL REGION RESIDENT CLINIC