National Provider Identifier Database

JEFFERSON CITY MEDICAL GROUP PC
Gynecology

A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions.


Contact Information

JEFFERSON CITY MEDICAL GROUP, P.C.
1241 W STADIUM BLVD
SUITE 1140
JEFFERSON CITY, MO65109-6023
Phone: 573-556-7717
Fax: 573-556-1717
Website:
Specialty Taxonomy Code
* Gynecology 207VG0400X

* Indicates primary specialty

NPI Profile & details for JEFFERSON CITY MEDICAL GROUP, P.C.

NPI Number 1467518423
Legal business name
LBN
JEFFERSON CITY MEDICAL GROUP, P.C.
Authorized official MICHAEL CRAIGHEAD - (COO)
Entity Organization
Organization subpart No
Enumeration date 12/27/2006
Last updated 05/12/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • MO Medicaid: 507560001
  • MO Other: CC7852 MEDICARE RAILROAD

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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