Primary Care of Bonne Terre LLC
Primary Care of Bonne Terre LLC provides General Practice Physician services in Bonne Terre, Missouri. Registered with an NPI since 2015.
- In the registry since
- 2015
- Specialties on file
- 2
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
527 Benham StBonne Terre, MO 63628-1205 Not confirmed with CMS for 10 years — call before visiting
Phone: (573) 358-9119
Fax: (573) 358-9489
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Physician (primary) | Taxonomy 208D00000X |
|---|---|
| Primary Care Clinic/Center | Taxonomy 261QP2300X |
Record details
| NPI number | 1962883751 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Andrew Ninichuck — Owner · (573) 358-9119 |
| Other names | Primary Care Of Bonne Terre |
| NPI enumerated | June 17, 2015 |
| Last updated in NPPES | November 23, 2015 |
| Mailing address | 527 Benham St, Bonne Terre, MO 63628-1205 |
Other providers in Bonne Terre
-
Mr. Andrew John Ninichuck, MD
527 Benham St, Bonne Terre, MO 63628-1205 · (573) 358-9119