# ST JOHNS CLINIC INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** SJC Women's Health Huntsville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710187588
- **Authorized official:** DONN E. SORENSEN (SENIOR VICE PRESIDENT)
- **Authorized official phone:** (417) 829-4264

## Contact information

- **Practice address:** 705 PHILLIPS, HUNTSVILLE, AR 72740
- **Practice address phone:** (479) 738-1700
- **Mailing address:** PO BOX 2580, SPRINGFIELD, MO 65801-2580
- **Mailing address phone:** (417) 829-4620
- **Mailing address fax:** (417) 829-4316

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | E4990 | AR | Yes |

## Other

- **Enumeration date:** 07/20/2007
- **Last updated:** 06/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 166387002 | — | AR |
| 01 | — | 5F873 | AR BLUE SHIELD | AR |