National Provider Identifier Database

JEFFERSON CITY MEDICAL GROUP PC
Multi-Specialty


Contact Information

JEFFERSON CITY MEDICAL GROUP, P.C.
1241 W STADIUM BLVD
FIRST FLOOR, SUITE 1100
JEFFERSON CITY, MO65109
Phone: 573-556-5747
Fax: 573-636-9756
Website:
Specialty Taxonomy Code
* Multi-Specialty 261QM1300X

* Indicates primary specialty

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

NPI Number 1336189398
Legal business name
LBN
JEFFERSON CITY MEDICAL GROUP, P.C.
Authorized official JEFFREY PATRICK - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 06/07/2006
Last updated 06/08/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • MO Other: CC7852 MEDICARE RAILROAD
  • MO Other: CD6058 MEDICARE RAILROAD
  • MO Other: CD6059 MEDICARE RAILROAD
  • MO Other: CD6060 MEDICARE RAILROAD
  • MO Other: CD6061 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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