Organization
WEST PLAINS SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA M. WORLEY (ADMINISTRATOR)
(417) 256-1400
Entity
Organization
Contact information
Practice address
1401 DOCTORS DR, WEST PLAINS, MO 65775-4754
(417) 256-1400
(417) 256-2885
Mailing address
1401 DOCTORS DR, WEST PLAINS, MO 65775-4754
(417) 256-1400
(417) 256-2885
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
160-0
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000040088
MEDICARE PTAN
MO
01
—
160-0
STATE LICENSE
MO
05
—
507268902
—
MO
Enumeration date
09/27/2005
Last updated
07/10/2015
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