Organization
MERCY CLINIC SPRINGFIELD COMMUNITIES
Active
Other names
Mercy Clinic Family Medicine-Mountain Grove
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM ROBERTS (CFO)
(417) 820-7363
Entity
Organization
Contact information
Practice address
120 W 16TH ST, MOUNTAIN GROVE, MO 65711
(417) 926-6111
(417) 926-6115
Mailing address
120 W 16TH ST, MOUNTAIN GROVE, MO 65711-1039
(417) 820-7133
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R9C21
MO
261QR1300X
Rural Health Clinic/Center
Primary
—
MO
363LF0000X
Family Nurse Practitioner
119291
MO
363LF0000X
Family Nurse Practitioner
130675
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
597932300
—
MO
Enumeration date
03/06/2007
Last updated
10/14/2025
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