Southern Missouri Family Medicine, LLC
Clinic/Center, Primary Care in West Plains, MO. Organization (NPI-2).
NPI number1154584308
StatusActive
Last updated in NPPESMar 17, 2010
Details
- NPI
- 1154584308
- Entity type
- Organization (NPI-2)
- Legal business name
- Southern Missouri Family Medicine, LLC
- Organization subpart
- No
- Enumeration date
- Jul 8, 2008
- Last updated
- Mar 17, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | R5G97 | MO | Yes |
Practice location
1625 Gibson StWest Plains, MO 65775-1873
Phone 417-256-3717 · Fax 417-256-3738
Mailing address
1402 N Kentucky AveWest Plains, MO 65775-1822
Phone 417-256-3717 · Fax 417-256-3738
Authorized official
James E Thompson
Owner
4172563717
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