Organization
MERCY CLINIC-SPRINGFIELD COMMUNITIES
Active
Other names
MERCY CLINIC-BERRYVILLE-WALMART
Organization subpart
No
Provider details
NPI number
Authorized official
DONN E. SORENSEN (EXECUTIVE VICE PRESIDENT, COO)
(417) 820-6556
Entity
Organization
Contact information
Practice address
1000 W TRIMBLE AVE, BERRYVILLE, AR 72616-4603
(870) 423-4472
(870) 423-7178
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A01264
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083924294
—
AR
Enumeration date
10/21/2010
Last updated
08/13/2013
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