Eastern Missouri General Services Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R9A44 Issued in MO

Legal business name

EASTERN MISSOURI GENERAL SERVICES INC

Practice address

322 No State Street
Desloge, MO 63601-3052

Phone

(573) 431-4510

Fax

(573) 431-4790

NPI assigned

Dec 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Riohard Martin Secor Jr., DO

Title

President Physician

Phone

(573) 431-4510

Specialties & licenses 2

Addresses

Other identifiers 6

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467518464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 NO STATE STREET",
            "city": "DESLOGE",
            "state": "MO",
            "postal_code": "636013052",
            "telephone_number": "573-431-4510",
            "fax_number": "573-431-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 NO STATE STREET",
            "city": "DESLOGE",
            "state": "MO",
            "postal_code": "636013052",
            "telephone_number": "573-431-4510",
            "fax_number": "573-431-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN MISSOURI GENERAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SECOR",
        "authorized_official_first_name": "RIOHARD",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT PHYSICIAN",
        "authorized_official_telephone_number": "573-431-4510",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "10179",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R9A44",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "0130013",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "04232001",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HL HEALTHLINK",
            "identifier": "101430",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4384846",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP GROUP HEALTH PLAN",
            "identifier": "103",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "25000",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Desloge, MO
• Providers in Desloge, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.