Provider Demographics
NPI:1154525053
Name:JULIA E MCNABB, D.O. LLC
Entity type:Organization
Organization Name:JULIA E MCNABB, D.O. LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCNABB
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:660-626-5413
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:QUEEN CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63561-0040
Mailing Address - Country:US
Mailing Address - Phone:660-766-2300
Mailing Address - Fax:626-593-4791
Practice Address - Street 1:513 N OLIVE ST
Practice Address - Street 2:
Practice Address - City:QUEEN CITY
Practice Address - State:MO
Practice Address - Zip Code:63561-1054
Practice Address - Country:US
Practice Address - Phone:660-766-2300
Practice Address - Fax:626-593-4791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care