Southeast Missouri Residential Services-Poplar Bluff Prof Grp

LBN: State Of Missouri
Southeast Missouri Residential Services-Poplar Bluff Prof Grp is an health care organization with primary practice located at 2351 Kanell Blvd , Poplar Bluff MO 63901-4035. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. State Of Missouri can be contacted via phone (573) 840-9370, or through Boeckmann, Molly Jane via phone (573) 751-4055.

Contact Information

Primary practice address
2351 Kanell Blvd Poplar Bluff MO 63901-4035
Phone: (573) 840-9370
Fax: (573) 840-9373
Website:
Map and Directions
Authorized official contact:
Name: Boeckmann, Molly Jane
Phone: (573) 751-4055

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1740560580
LBN Legal business name State Of Missouri
DBA Doing business as Southeast Missouri Residential Services-Poplar Bluff Prof Grp
Authorized official Boeckmann, Molly Jane
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 25th, 2011
Last updated Oct 15th, 2020 - about 6 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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