Jefferson Medical Group
LBN: Jefferson Medical Group
Jefferson Medical Group is an health care organization with primary practice located at 1502 N Jefferson St , Carrollton MO 64633-1948. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Rural Health. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Jefferson Medical Group can be contacted via phone (660) 542-9998, or through Ireland, Amy Danielle via phone (660) 329-6005.
Contact Information
Primary practice address
1502 N Jefferson St
Carrollton MO 64633-1948
Phone: (660) 542-9998
Fax: (660) 542-9880
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Ambulatory Health Care Facilities / Rural Health | 261QR1300X |
Profile Details
| NPI number | 1215030713 |
|---|---|
| LBN Legal business name | Jefferson Medical Group |
| DBA Doing business as | |
| Authorized official | Ireland, Amy Danielle |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 7th, 2006 |
| Last updated | Oct 29th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215030713 | NPPES |
| Missouri | MEDICAID | 50899330 |
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