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Contact Information

JEFFERSON CITY MEDICAL GROUP, PC
1241 W STADIUM BLVD
JEFFERSON CITY, MO65109-6023
 Phone: 573-635-5264
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for JEFFERSON CITY MEDICAL GROUP, PC

NPI Number 1235723701
LBN Legal business name JEFFERSON CITY MEDICAL GROUP, PC
Authorized official PHYLLIS BLAKE - (DIRECTOR OF REVENUE CYCLE)
Entity Organization
Organization subpart 1 No
Enumeration date 02/25/2021
Last updated 02/25/2021 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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