# FAMILY WALK IN CLINIC OF MOUNTAIN GROVE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FAMILY WALK-IN CLINIC OF MTN. GROVE, INC.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083705529
- **Authorized official:** DR. KENNETH H DUGAN M.D. (VICE-PRESIDENT)
- **Authorized official phone:** (417) 926-3743

## Contact information

- **Practice address:** 205 W 3RD ST STE 3, MOUNTAIN GROVE, MO 65711-1600
- **Practice address phone:** (417) 926-3743
- **Practice address fax:** (417) 926-7625
- **Mailing address:** 205 W 3RD ST STE 3, MOUNTAIN GROVE, MO 65711-1600
- **Mailing address phone:** (417) 926-3743
- **Mailing address fax:** (417) 926-7625

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/28/2006
- **Last updated:** 11/12/2014