Organization
MERCY CLINIC SPRINGFIELD COMMUNITIES
Active
Other names
Mercy Clinic-Agape Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT CAVAGNOL (CHIEF PHYSICIAN OFFICER)
(417) 820-2705
Entity
Organization
Contact information
Practice address
331 HOSPITAL DR, SUITE C, LEBANON, MO 65536
(417) 533-6500
(417) 533-6555
Mailing address
645 MARYVILLE CENTRE DR FL 3, SAINT LOUIS, MO 63141-5855
(417) 820-7133
(417) 820-0586
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
105131
MO
261QR1300X
Rural Health Clinic/Center
Primary
—
MO
363A00000X
Physician Assistant
2002018364
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
595979907
—
MO
Enumeration date
03/05/2007
Last updated
12/04/2018
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