NPI Registry.org

Fcc Medical Clinics Llc

NPI Registration Record

Provider / OrganizationNPIDate Certified
FCC MEDICAL CLINICS LLC12155104902021-07-12

The organization Fcc Medical Clinics Llc is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1215510490. Registration indicates Fcc Medical Clinics Llc is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Internal Medicine Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Internal Medicine) (Internal Medicine, ) (Allopathic & Osteopathic Physicians, Internal Medicine) (Primary Care/Family Planning/APRN/PA, ) (Internal Medicine, Allopathic & Osteopathic Physicians) (Ambulatory Health Care Facilities, Clinic/Center) (Clinic/Center, ) (All Other Specialties & Provider Types, ) (Clinic/Center, Ambulatory Health Care Facilities)

Other Names:
Entity TypeOrganization
Provider OrganizationFCC MEDICAL CLINICS LLC
Other Provider OrganizationFCC PRIMARY CARE CLINIC POPLAR BLUFF
Practice Office Address3001 WARRIOR LN
POPLAR BLUFF, MO US
Practice Office Telephone5736861200
Practice Office Fax5737789492
Mailing AddressPO BOX 71
KENNETT, MO 638570071 US
Authorized OfficialTRACY ELLIS, CCO
5738885925
HPT Codes
CodePractice
License No
State
207R00000X PRIMARYAccess to Adult/Geriatric Primary Care Providers
Allopathic & Osteopathic Physicians
Internal MedicineAccess to Pediatric Primary Care Providers
Allopathic & Osteopathic Physicians
Internal Medicine
Internal Medicine

Allopathic & Osteopathic Physicians
Internal Medicine
Primary Care/Family Planning/APRN/PA

Internal Medicine
Allopathic & Osteopathic Physicians
261Q00000X
Ambulatory Health Care Facilities
Clinic/Center
Clinic/Center

All Other Specialties & Provider Types

Clinic/Center
Ambulatory Health Care Facilities
193200000X MULTGroup Code
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]

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