Provider Demographics
NPI:1063195923
Name:MCPHERSON MEDICAL & DIAGNOSTIC, LLC
Entity type:Organization
Organization Name:MCPHERSON MEDICAL & DIAGNOSTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ABDULLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ARSHAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-724-0083
Mailing Address - Street 1:901 W COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT
Mailing Address - State:MO
Mailing Address - Zip Code:63857-1100
Mailing Address - Country:US
Mailing Address - Phone:573-695-2181
Mailing Address - Fax:573-695-2796
Practice Address - Street 1:10345 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1105
Practice Address - Country:US
Practice Address - Phone:314-965-6033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty