# MERCY CLINIC SPRINGFIELD COMMUNITIES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mercy Clinic Family Medicine Ava
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770618233
- **Authorized official:** STUART G. STANGELAND (SENIOR VICE PRESIDENT, COO)
- **Authorized official phone:** (417) 820-6556

## Contact information

- **Practice address:** 1312 NORTH HIGHWAY 5, AVA, MO 65608
- **Practice address phone:** (417) 683-4045
- **Practice address fax:** (417) 683-6069
- **Mailing address:** PO BOX 505164, SAINT LOUIS, MO 63150-5164
- **Mailing address phone:** (417) 820-2000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 113969 | MO | — |
| 261QR1300X | Rural Health Clinic/Center | — | MO | Yes |
| 363LF0000X | Family Nurse Practitioner | 122348 | MO | — |

## Other

- **Enumeration date:** 02/23/2007
- **Last updated:** 04/28/2015