Carthage Children'S Clinic, LLC

Organization Active NPI Pediatric Adolescent Medicine Physician · Carthage, MO

NPI 1073916623 · NPPES record last updated Sep 26, 2014

Key facts

NPI
1073916623
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Adolescent Medicine Physician 2080A0000X
License
R7F62 (MO)
Legal business name
CARTHAGE CHILDREN'S CLINIC, LLC
Practice address
1221 Oak St
Carthage, MO 64836-2028
Phone
(417) 359-9291
Fax
(417) 359-9241
NPI assigned
Sep 26, 2014
Organization subpart
No

Authorized official

Name
Denise M Hamar, D.O.
Title
Owner
Phone
(417) 359-9291

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Carthage Children'S Clinic LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
2080A0000X R7F62 MO Yes

Addresses

Primary practice location

1221 Oak St
Carthage, MO 64836-2028

Mailing address

1221 Oak St
Carthage, MO 64836-2028
Phone (417) 359-9291

Other providers in Carthage, MO

All providers in Carthage, MO · Pediatric Adolescent Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.