Organization
MERCY CLINIC SPRINGFIELD COMMUNITIES
Active
Other names
MERCY CLINIC EAR, NOSE & THROAT-BERRYVILLE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STUART G. STANGELAND (SENIOR VICE PRESIDENT/COO)
(417) 820-6556
Entity
Organization
Contact information
Practice address
613 ORCHARD DR, BERRYVILLE, AR 72616-5013
(870) 423-4240
(870) 423-4241
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
E0693
AR
207Y00000X
Otolaryngology Physician
Primary
R8E81
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150959002
—
AR
05
—
500147301
—
MO
Enumeration date
06/10/2006
Last updated
10/29/2013
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