# MERCY CLINIC SPRINGFIELD COMMUNITIES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MERCY CLINIC-FAMILY MEDICINE BERRYVILLE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740226091
- **Authorized official:** BJ ROBERTS (CFO)
- **Authorized official phone:** (417) 820-7363

## Contact information

- **Practice address:** 207 CARTER ST, BERRYVILLE, AR 72616-4303
- **Practice address phone:** (870) 423-6661
- **Practice address fax:** (870) 423-4374
- **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 | R6D08 | AR | Yes |

## Other

- **Enumeration date:** 06/22/2006
- **Last updated:** 04/30/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 128620002 | — | AR |
| 05 | — | 501625800 | — | MO |
| 01 | — | CR0464 | TRAVELERS/RR MEDICARE \# | AR |