Organization
FAYETTEVILLE VAMC
Active
Other names
SPRINGFIELD VA CLINIC, Mount Vernon VA CBOC
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN POTTER (NPI TEAM MEMBER)
(202) 382-2579
Entity
Organization
Contact information
Practice address
1850 W REPUBLIC RD, SPRINGFIELD, MO 65807-5730
(615) 355-3451
Mailing address
PO BOX 94494, CLEVELAND, OH 44101
(615) 355-3451
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
—
—
Other
Enumeration date
05/18/2006
Last updated
01/22/2019
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