Organization
MERCY CLINIC SPRINGFIELD COMMUNITIES
Active
Other names
Mercy Clinic-Rolla-Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
STUART STANGELAND (CHIEF OPERATING OFFICER)
(417) 820-6556
Entity
Organization
Contact information
Practice address
1605 MARTIN SPRINGS DR, SUITE 260, ROLLA, MO 65401-2931
(573) 458-6358
(573) 458-6464
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 820-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2002026119
MO
207RP1001X
Pulmonary Disease Physician
2004035776
MO
261QR1300X
Rural Health Clinic/Center
Primary
—
MO
363L00000X
Nurse Practitioner
135755
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
590094504
—
MO
Enumeration date
08/13/2006
Last updated
04/07/2015
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