Organization
MERCY CLINIC-SPRINGFIELD COMMUNITIES
Active
Other names
Mercy Clinic Family Medicine-Houston
Organization subpart
No
Provider details
NPI number
Authorized official
STUART G. STANGELAND (SENIOR VICE PRESIDENT/COO)
(417) 820-3873
Entity
Organization
Contact information
Practice address
1422 S SAM HOUSTON BLVD, HOUSTON, MO 65483
(417) 967-4445
(417) 967-4453
Mailing address
645 MARYVILLE CENTRE DR FL 3, SAINT LOUIS, MO 63141-5855
(417) 820-7133
(417) 820-0586
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2005013261
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
—
597932607
—
MO
Enumeration date
03/05/2007
Last updated
06/12/2018
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