Organization
ST. JOHN'S PHYSICIANS & CLINICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONN E. SORENSEN (SENIOR VICE PRESIDENT/COO)
(417) 820-6556
Entity
Organization
Contact information
Practice address
620 S GLENSTONE AVE, ST. JOHN'S PHYSICIANS & CLINICS, INC., SPRINGFIELD, MO 65802-3206
(417) 829-4620
(417) 829-4316
Mailing address
1965 S FREMONT AVE, ST. JOHN'S PHYSICIANS & CLINICS, INC., SPRINGFIELD, MO 65804-2201
(417) 829-4264
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502606502
—
MO
Enumeration date
06/15/2006
Last updated
09/22/2008
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