Provider Demographics
NPI:1275664344
Name:FAMILY HEALTH ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:FAMILY HEALTH ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOLENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:OSTWINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:417-532-7850
Mailing Address - Street 1:341 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:MO
Mailing Address - Zip Code:65536-9217
Mailing Address - Country:US
Mailing Address - Phone:417-532-7850
Mailing Address - Fax:417-532-2451
Practice Address - Street 1:341 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:MO
Practice Address - Zip Code:65536-9217
Practice Address - Country:US
Practice Address - Phone:417-532-7850
Practice Address - Fax:417-532-2451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000012245OtherMEDICARE SERVICES
MO503735508Medicaid