Northeast Missouri Ambulatory Surgery Center

NPI Provider: 1710982699
Contact Name: Johnson Matthew
Position: Administrator
Phone: (573) 406-1301

Northeast Missouri Ambulatory Surgery Center Information:

Northeast Missouri Ambulatory Surgery Center organization have npi 1710982699, taxonomy code is 261QA1903X with license number is 108 in . This Business address located in PO Box 511, Hannibal, MO 63401 Missouri.

Practice Location
Address: 98 Medical Drive, Hannibal, MO 63401
Phone: (573) 406-1301

Business Location
Address: PO Box 511, Hannibal, MO 63401
Phone: (573) 406-1301
Fax: (573) 406-0511

Taxonomy

Taxonomy Code: 261QA1903X

License Number: 108

License Number of State: MO

Primary Taxonomy Switch: Y

Enumeration Date: 6/16/2005

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