# PHELPS COUNTY REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Phelps Health Medical Group Waynesville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447430574
- **Authorized official:** JANA MARIE COOK (CFO/SR. VP)
- **Authorized official phone:** (573) 458-7916

## Contact information

- **Practice address:** 1000 GW LANE, WAYNESVILLE, MO 65583-5401
- **Practice address phone:** (573) 774-2715
- **Practice address fax:** (573) 774-2792
- **Mailing address:** PO BOX 579, ROLLA, MO 65402-0579
- **Mailing address phone:** (573) 426-2182
- **Mailing address fax:** (573) 426-5341

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 2007024375 | MO | — |
| 261QR1300X | Rural Health Clinic/Center | — | MO | Yes |

## Other

- **Enumeration date:** 11/06/2007
- **Last updated:** 02/02/2023