Organization
MERCY CLINIC HOSPITALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA A CROCKETT-MAPLES MD (PHYSICIAN)
(417) 820-2600
Entity
Organization
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2600
(417) 820-2100
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4414
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
103374
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505773408
—
MO
01
—
DN0526
RAILROAD MEDICARE
MO
Enumeration date
02/01/2006
Last updated
04/24/2012
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