Vienna Family Practice LLC

Organization Active NPI Family Medicine Physician · Vienna, MO

NPI 1326328295 · NPPES record last updated Aug 24, 2011

Key facts

NPI
1326328295
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
VIENNA FAMILY PRACTICE LLC
Practice address
111 Parkway
Vienna, MO 65582-8003
Phone
(573) 422-3360
Fax
(573) 422-3391
NPI assigned
Aug 24, 2011
Organization subpart
No

Authorized official

Name
Keith Edward Segall, DO
Title
Sole Member
Phone
(573) 422-3360

National Provider Directory

Locations

111 Parkway
Vienna, MO 65582
Phone (573) 422-3360

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

111 Parkway
Vienna, MO 65582-8003

Mailing address

111 Parkway
Vienna, MO 65582-8003
Phone (573) 422-3360

Other providers in Vienna, MO

All providers in Vienna, MO · Family Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.