EBO MD OF POPLAR BLUFF LLC
NPI 1770152035
Family Medicine in Poplar Bluff, MO
- Organization
- Family Medicine
- CLIA Number: 26D2229143
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-06-2027
About EBO MD OF POPLAR BLUFF LLC
This page provides the complete NPI Profile along with additional information for Ebo Md Of Poplar Bluff Llc, a primary care provider established in Poplar Bluff, Missouri operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1770152035 assigned on June 2021. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mr. Philip James Crocker (Cfo)
- NPI
- 1770152035 Verify this NPI
- Provider Name
- EBO MD OF POPLAR BLUFF LLC
- Entity Type
- Organization
- Location Address
- 2725 N WESTWOOD BLVD POPLAR BLUFF, MO 63901
- Location Phone
- (573) 686-5510
- Mailing Address
- 2725 N WESTWOOD BLVD STE 14 POPLAR BLUFF, MO 63901
- Mailing Phone
- (573) 686-5510
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-22-2021
- Last Update Date
- 07-26-2021
- Code Navigator
A primary care provider (PCP) like Ebo Md Of Poplar Bluff Llc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 26D2229143
- Facility Type
- Physician Office
- Certificate Effective Date
- July 07, 2025
- Certificate Expiration Date
- July 06, 2027
- Laboratory Director
- TAMMY J. LINDSAY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Ebo Md Of Poplar Bluff Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
POPLAR BLUFF, MO 63901
POPLAR BLUFF, MO 63901
POPLAR BLUFF, MO 63901
POPLAR BLUFF, MO 63901
POPLAR BLUFF, MO 63901
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770152035, enumerated as an "organization" on June 22, 2021.
The provider is located at 2725 N WESTWOOD BLVD POPLAR BLUFF, MO 63901 and the phone number is (573) 686-5510.
Family Medicine with taxonomy code 207Q00000X.
