PHYSICIAN SERVICES OF MISSOURI LLC – NPI #1164792032
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

PHYSICIAN SERVICES OF MISSOURI LLC is a provider located in KIRKSVILLE, MO. NPPES has assigned the NPI number 1164792032 to PHYSICIAN SERVICES OF MISSOURI LLC on January 09, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was last updated on May 21, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PHYSICIAN SERVICES OF MISSOURI LLC below.

NPI Profile for
PHYSICIAN SERVICES OF MISSOURI LLC

NPI Number
1164792032
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PHYSICIAN SERVICES OF MISSOURI LLC
Primary location
1611 S BALTIMORE ST
KIRKSVILLE, MO 63501-4536
Phone: (859) 514-5547 Fax: (859) 422-4907
Mailing address
989 GOVERNORS LN
SUITE 160
LEXINGTON, KY 40513-1173
Phone: (859) 514-5547 Fax: (859) 422-4907
Organization Subpart
Yes - PHYSICIAN SERVICES OF MISSOURI LLC is subpart of another organization.
Authorized Official
CASEY DELOACH
MANAGER
Phone: (888) 829-8550
Updated
Certification Date
May 21, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for PHYSICIAN SERVICES OF MISSOURI LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherMEDICARE PTANPHC059
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.