Ebo MD of Poplar Bluff LLC
NPI 1770152035ActiveOrganization· Family Medicine· Poplar Bluff, MO
Family Medicine in Poplar Bluff, Missouri, registered in NPPES in June 2021. The authorized official on file is Philip James Crocker, Cfo.
Overview
| NPI | 1770152035 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 22, 2021 |
| Last updated in NPPES | Jul 26, 2021 |
| Certified by provider | Jul 1, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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