Provider Demographics
NPI:1164164711
Name:CORNERSTONE FAMILY MEDICINE LLC
Entity Type:Organization
Organization Name:CORNERSTONE FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:TREAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-437-9917
Mailing Address - Street 1:605 E PROMENADE ST
Mailing Address - Street 2:
Mailing Address - City:MEXICO
Mailing Address - State:MO
Mailing Address - Zip Code:65265-2926
Mailing Address - Country:US
Mailing Address - Phone:573-200-6078
Mailing Address - Fax:833-817-7109
Practice Address - Street 1:605 E PROMENADE ST
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-2926
Practice Address - Country:US
Practice Address - Phone:573-200-6078
Practice Address - Fax:833-817-7109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center