Provider Demographics
NPI:1457034001
Name:MCPHERSON MEDICAL & DIAGNOSTIC, LLC
Entity Type:Organization
Organization Name:MCPHERSON MEDICAL & DIAGNOSTIC, LLC
Other - Org Name:AMERICAN MEDICAL MISSOURI
Other - Org Type:Doing Business As
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 1:211 TEACO RD
Practice Address - Street 2:
Practice Address - City:KENNETT
Practice Address - State:MO
Practice Address - Zip Code:63857-3236
Practice Address - Country:US
Practice Address - Phone:573-888-0001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty