# MERCY CLINIC SPRINGFIELD COMMUNITIES

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

## Provider details

- **NPI number:** 1962534727
- **Authorized official:** STUART STANGELAND (SENIOR VICE PRESIDENT)
- **Authorized official phone:** (417) 820-3873

## Contact information

- **Practice address:** 332 S MAIN AVE, REPUBLIC, MO 65738
- **Practice address phone:** (417) 732-5050
- **Practice address fax:** (417) 732-8061
- **Mailing address:** 645 MARYVILLE CENTRE DR FL 3, SAINT LOUIS, MO 63141-5855
- **Mailing address phone:** (417) 820-7133
- **Mailing address fax:** (417) 820-0586

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 107047 | MO | — |
| 261QR1300X | Rural Health Clinic/Center | — | MO | Yes |
| 363A00000X | Physician Assistant | 2001029957 | MO | — |
| 363LF0000X | Family Nurse Practitioner | 145564 | MO | — |

## Other

- **Enumeration date:** 03/09/2007
- **Last updated:** 06/11/2018