Carondelet Physician Services INC

NPI #1811293582 in Oak Grove, Missouri

Provider Information

NPI Number: 1811293582
Entity Type: Organization
Organization Name: Carondelet Physician Services INC
Subpart: Yes (part of a larger organization)
Parent Organization: CARONDELET HEALTH
Primary Specialty: Family Medicine
Enumeration Date: Jan 28, 2011
Last Updated: May 4, 2011

Practice Location

Address: 1900 S BROADWAY
City: Oak Grove
State: Missouri
ZIP Code: 64075-9020
Phone: (816) 690-6566

Authorized Official

Name: MR. STEVEN R CLEARY
Title: VP/CFO
Phone: (816) 943-2819

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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