Organization
MOUNTAIN GROVE MEDICAL AND LASER CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOYLE B HILL DO (OWNER)
(417) 926-6643
Entity
Organization
Contact information
Practice address
601 N BUSCH AVE, MOUNTAIN GROVE, MO 65711
(417) 926-6643
(417) 926-6317
Mailing address
1003 WOODSIDE AVE, ESSEXVILLE, MI 48732-1234
(989) 892-7722
(989) 892-7455
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053760769
—
MO
Enumeration date
06/03/2016
Last updated
05/14/2018
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