# MERCY CLINIC SPRINGFIELD COMMUNITIES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MERCY CLINIC-HOLIDAY ISLAND
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538195508
- **Authorized official:** MR. STUART G. STANGELAND (SENIOR VICE PRESIDENT/COO)
- **Authorized official phone:** (417) 820-6556

## Contact information

- **Practice address:** 1 PARK DR, SUITE C, HOLIDAY ISLAND, AR 72631-9216
- **Practice address phone:** (479) 363-9174
- **Practice address fax:** (479) 363-9175
- **Mailing address:** PO BOX 505164, SAINT LOUIS, MO 63150-5164
- **Mailing address phone:** (417) 829-4620

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | E1025 | AR | Yes |

## Other

- **Enumeration date:** 06/23/2006
- **Last updated:** 10/10/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 141392002 | — | AR |