Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Farmington Clinic Company LLC

Organization Family Medicine Physician · NPI 1063517613

Farmington Clinic Company LLC is a Family Medicine Physician in Fredericktown, Missouri. Licensed in Missouri. Registered with an NPI since 2006.

Licensed in
MO
In the registry since
2006
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

309 Garrett St
Fredericktown, MO 63645-1084
Phone: (573) 783-4683
Fax: (573) 783-4684
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (MO)
Rural Health Clinic/Center Taxonomy 261QR1300X

Record details

NPI number1063517613
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationFarmington Clinic Company LLC
Authorized official Michael Portacci — President · (615) 465-7029
Other names Fredericktown Primary Care
NPI enumeratedSeptember 14, 2006
Last updated in NPPESJuly 21, 2022
Mailing addressPo Box 504354, Saint Louis, MO 63150-0001

Other providers in Fredericktown