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

Icdoc LLC

Organization Primary Care Clinic/Center · NPI 1629756929

Icdoc LLC is a Primary Care Clinic/Center in Poplar Bluff, Missouri. Registered with an NPI since 2023.

In the registry since
2023
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

2445 N Westwood Blvd Ste 100
Poplar Bluff, MO 63901-2317
Phone: (573) 776-0157
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X

Record details

NPI number1629756929
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shelly Gresham — Member, Administrator · (573) 776-0157
NPI enumeratedJuly 6, 2023
Last updated in NPPESJuly 6, 2023
Certification dateJuly 6, 2023
Mailing address2445 N Westwood Blvd Ste 100, Poplar Bluff, MO 63901-2317

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