NPI 1649514050

Capital Region Resident Clinic

Organisation General Practice Physician Jefferson City, MO

Practice location

Address: 220 Madison St., Jefferson City, MO 65102
Phone: (573) 632-4900
Fax: (573) 644-6650
Mailing address: 1111 Madison St, Jefferson City, MO 65101-2753

Authorised official

Name: Tom Luebbering
Title: Vp of Finance
Phone: (573) 632-5100

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Missouri →

Registry record

NPI: 1649514050
Entity type: Organization
NPI issued: 26 Nov 2012
Record last updated: 10 Jun 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.