Provider Demographics
NPI:1790502086
Name:MCPHERSON MEDICAL & DIAGNOSTIC LLC
Entity type:Organization
Organization Name:MCPHERSON MEDICAL & DIAGNOSTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDULLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ARSHAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-724-0083
Mailing Address - Street 1:2102 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SCOTT CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63780-1337
Mailing Address - Country:US
Mailing Address - Phone:573-264-0042
Mailing Address - Fax:
Practice Address - Street 1:2102 MAIN ST
Practice Address - Street 2:
Practice Address - City:SCOTT CITY
Practice Address - State:MO
Practice Address - Zip Code:63780-1337
Practice Address - Country:US
Practice Address - Phone:573-264-0042
Practice Address - Fax:573-264-0087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health