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Organization
ST JOHNS CLINIC INC
Active
Organization
ST JOHNS CLINIC INC
Active
Other names
SJC-Cassville
Organization subpart
No
Provider details
NPI number
Authorized official
DONN E. SORENSEN (CHIEF OPERATING OFFICER)
(417) 829-4264
Entity
Organization
Contact information
Practice address
90 GRAVEL ST, CASSVILLE, MO 65625-1601
(417) 847-6045
(417) 847-6049
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R4E21
MO
261QR1300X
Rural Health Clinic/Center
Primary
—
MO
363A00000X
Physician Assistant
104182
MO
Other
Enumeration date
02/26/2007
Last updated
06/30/2008
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