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A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adolescent Medicine |
207QA0000X | 08 | Physician/Family Practice |
| NPI Number | 1629491105 |
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| LBN Legal business name | EXCELSIOR SPRINGS PHYSICIANS CLINIC | ||||||||
| Authorized official | JENNIFER BOOMGARDEN - (PHYSICIANS PRACTICE MANAGER) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 02/04/2014 | ||||||||
| Last updated | 02/04/2014 - About 12 years ago | ||||||||
| Identifiers |
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EXCELSIOR SPRINGS PHYSICIANS CLINIC
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EXCELSIOR SPRINGS PHYSICIANS CLINIC