Organization · Type 2 NPI

Farmington Clinic Company LLC

Family Medicine Physician · Fredericktown, MO

NPI number 1063517613 Active

Practice location

309 Garrett St
Fredericktown, MO 63645-1084

Call (573) 783-4683 Map

Fax (573) 783-4684

Mailing address

PO Box 504354
St. Louis, MO 63150-0001

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed
Rural Health Clinic/Center	261QR1300X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

8 other providers at this address

Other family medicine physician providers in Fredericktown

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NPI record

NPI: 1063517613
Entity type: Organization (Type 2)
Issued: Sep 14, 2006
Last updated: Jul 21, 2022
Status: Active
Subpart: Yes of Farmington Clinic Company LLC

Other names

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Fredericktown Primary Care · doing business as

Authorized official

Michael Portacci
President
(615) 465-7029

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1063517613

Farmington Clinic Company LLC's National Provider Identifier is 1063517613, issued on Sep 14, 2006. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Fredericktown, MO. The record was last updated on Jul 21, 2022.