# MERCY CLINIC SPRINGFIELD COMMUNITIES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mercy Clinic-Rolla-Internal Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457363806
- **Authorized official:** STUART STANGELAND (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (417) 820-6556

## Contact information

- **Practice address:** 1605 MARTIN SPRINGS DR, SUITE 260, ROLLA, MO 65401-2931
- **Practice address phone:** (573) 458-6358
- **Practice address fax:** (573) 458-6464
- **Mailing address:** PO BOX 505164, SAINT LOUIS, MO 63150-5164
- **Mailing address phone:** (417) 820-2000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 2002026119 | MO | — |
| 207RP1001X | Pulmonary Disease Physician | 2004035776 | MO | — |
| 261QR1300X | Rural Health Clinic/Center | — | MO | Yes |
| 363L00000X | Nurse Practitioner | 135755 | MO | — |

## Other

- **Enumeration date:** 08/13/2006
- **Last updated:** 04/07/2015