Poplar Bluff Pediatric Assoc Ll
NPI #1275676355 in Poplar Bluff, Missouri
Provider Information
- NPI Number
- 1275676355
- Entity Type
- Organization
- Organization Name
- Poplar Bluff Pediatric Assoc Ll
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Feb 15, 2007
- Last Updated
- Oct 5, 2017
Practice Location
- Address
- 2210 BARRON RD
- Address 2
- SUITE 120
- City
- Poplar Bluff
- State
- Missouri
- ZIP Code
- 63901-1908
- Phone
- (573) 785-2005
Authorized Official
- Name
- MRS. TIFFANY L MOSS
- Title
- OFFICE MANAGER
- Phone
- (573) 785-2005
Specialties & Taxonomy Codes
| Specialty |
|---|
| General Practice |
| Clinic/Center |
| Clinic/Center - Rural Health — Rural Health |
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