# OZARK VALLEY MEDICAL CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LIFT UP SOMEONE TODAY
- **Other names:** Lift Up Someone Today
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639686850
- **Legal business name:** LIFT UP SOMEONE TODAY
- **Authorized official:** DR. PATRICIA ASHTON DERGES MD (CEO/OWNER)
- **Authorized official phone:** (417) 317-5330

## Contact information

- **Practice address:** 5571 N 21ST ST, OZARK, MO 65721-7488
- **Practice address phone:** (417) 317-5330
- **Practice address fax:** (417) 763-3370
- **Mailing address:** 5571 N 21ST ST, OZARK, MO 65721-7488
- **Mailing address phone:** (417) 317-5330
- **Mailing address fax:** (417) 763-3370

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2017017409 | MO | — |
| 207Q00000X | Family Medicine Physician | 2017024744 | MO | — |
| 207Q00000X | Family Medicine Physician | 2017032792 | MO | Yes |
| 208VP0000X | Pain Medicine Physician | 2017032792 | MO | — |

## Other

- **Enumeration date:** 01/09/2018
- **Last updated:** 03/17/2018