Organization
PHELPS COUNTY REGIONAL MEDICAL CENTER
Active
Other names
Phelps Health Medical Group Waynesville
Organization subpart
No
Provider details
NPI number
Authorized official
JANA MARIE COOK (CFO/SR. VP)
(573) 458-7916
Entity
Organization
Contact information
Practice address
1000 GW LANE, WAYNESVILLE, MO 65583-5401
(573) 774-2715
(573) 774-2792
Mailing address
PO BOX 579, ROLLA, MO 65402-0579
(573) 426-2182
(573) 426-5341
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2007024375
MO
261QR1300X
Rural Health Clinic/Center
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
596499509
—
MO
Enumeration date
11/06/2007
Last updated
02/02/2023
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