# SKAGGS COMMUNITY HOSPITAL ASSOCIATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Skaggs Roark Valley Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134355563
- **Authorized official:** DR. PETER R MARCELLUS MD (CHIEF MEDICAL OFFICER)
- **Authorized official phone:** (417) 335-7000

## Contact information

- **Practice address:** 121 CAHILL RD, SUITE 201, BRANSON, MO 65616-2036
- **Practice address phone:** (417) 335-7555
- **Practice address fax:** (417) 335-7588
- **Mailing address:** PO BOX 770, BRANSON, MO 65615-0770
- **Mailing address phone:** (417) 348-8611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 52-51 | MO | Yes |

## Other

- **Enumeration date:** 05/29/2009
- **Last updated:** 07/27/2009