# MCCUNE BROOKS REGIONAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MCCUNE BROOKS REGIONAL HOSPITAL
- **Other names:** CARTHAGE PEDIATRICS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1336381755
- **Legal business name:** MCCUNE BROOKS REGIONAL HOSPITAL
- **Authorized official:** MR. ROBERT Y COPELAND (CEO)
- **Authorized official phone:** (417) 358-8121

## Contact information

- **Practice address:** 1911 BUENA VISTA AVE, CARTHAGE, MO 64836-3178
- **Practice address phone:** (417) 237-0983
- **Practice address fax:** (417) 237-0997
- **Mailing address:** 1911 BUENA VISTA AVE, CARTHAGE, MO 64836-3178
- **Mailing address phone:** (417) 237-0983
- **Mailing address fax:** (417) 237-0997

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 100685 | MO | Yes |

## Other

- **Enumeration date:** 03/31/2009
- **Last updated:** 01/26/2012