| Organization Name: | REPUBLIC FAMILY MEDICAL WALK-IN CLINIC, INC. |
| NPI Number: | 1235100819 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL J. BURKE (OWNER/MEDICAL DIRECTOR) |
| Mailing Address: | 281 Us Highway 60 W Republic |
| State: | MO US |
| Postal Code: | 657381432 |
| Phone Number: | 4177326277 |
| Fax Number: | 4177326225 |
| NPI Enumeration Date: | 01/31/2006 |
| NPI Last Update Date: | 04/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | R5B57 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |