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Specialty details in registry · Hannibal, MO

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At a glance

511 Birch St, Hannibal, MO 63401-5001

NPPES record updated Aug 22, 2020. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

511 Birch St
Hannibal, MO 63401-5001
Professional details: NPI, taxonomy & registry record
NPI1760607766
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
320600000X
Enumeration date
Apr 16, 2007
Record updated
Aug 22, 2020
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

320600000X · Primary

License reported: 2588-8531 MO

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

511 Birch St
Hannibal, MO 63401-5001
Phone
(573) 221-0297
Fax
(573) 406-1418
Mailing address
511 BIRCH ST

HANNIBAL, MO 634015001
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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