# ST JOHNS CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SJC-Cassville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740316728
- **Authorized official:** DONN E. SORENSEN (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (417) 829-4264

## Contact information

- **Practice address:** 90 GRAVEL ST, CASSVILLE, MO 65625-1601
- **Practice address phone:** (417) 847-6045
- **Practice address fax:** (417) 847-6049
- **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 |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | R4E21 | MO | — |
| 261QR1300X | Rural Health Clinic/Center | — | MO | Yes |
| 363A00000X | Physician Assistant | 104182 | MO | — |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 06/30/2008