Oak Grove Medical Clinic

LBN: Carondelet Physician Services Inc
Oak Grove Medical Clinic is an health care organization with primary practice located at 1900 S Broadway , Oak Grove MO 64075-9020. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Carondelet Physician Services Inc can be contacted via phone (816) 690-6566, or through Cleary, Steven R via phone (816) 943-2819.

Contact Information

Primary practice address
1900 S Broadway Oak Grove MO 64075-9020
Phone: (816) 690-6566
Fax: (816) 625-8276
Website:
Map and Directions
Authorized official contact:
Name: Cleary, Steven R
Phone: (816) 943-2819

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 34421 Missouri

Profile Details

NPI number 1811293582
LBN Legal business name Carondelet Physician Services Inc
DBA Doing business as Oak Grove Medical Clinic
Authorized official Cleary, Steven R
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 28th, 2011
Last updated May 4th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811293582 NPPES
Missouri MEDICAID 501269500
Missouri Other 39532013

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