Northeast Missouri Medical Providers LLC

NPI #1427409713 in Louisiana, Missouri

Provider Information

NPI Number: 1427409713
Entity Type: Organization
Organization Name: Northeast Missouri Medical Providers LLC
Primary Specialty: Emergency Medicine
Enumeration Date: Jun 28, 2016
Last Updated: Jun 15, 2021

Practice Location

Address: 2305 GEORGIA ST
City: Louisiana
State: Missouri
ZIP Code: 63353-2559
Phone: (469) 401-2386

Authorized Official

Name: KATHLEEN KONDAS
Title: OFFICER
Phone: (973) 251-1132

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X	Primary

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