Ebo MD of Poplar Bluff LLC
NPI #1770152035 in Poplar Bluff, Missouri
Provider Information
- NPI Number
- 1770152035
- Entity Type
- Organization
- Organization Name
- Ebo MD of Poplar Bluff LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Jun 22, 2021
- Last Updated
- Jul 26, 2021
Practice Location
- Address
- 2725 N WESTWOOD BLVD
- City
- Poplar Bluff
- State
- Missouri
- ZIP Code
- 63901-2346
- Phone
- (573) 686-5510
Authorized Official
- Name
- MR. PHILIP JAMES CROCKER
- Title
- CFO
- Phone
- (573) 686-5510
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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