Organization
MERCY CLINIC SPRINGFIELD COMMUNITIES
Active
Other names
Mercy Clinic-Head & Neck Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
BJ ROBERTS (CFO)
(417) 820-7363
Entity
Organization
Contact information
Practice address
1229 E SEMINOLE ST, SPRINGFIELD, MO 65804-2227
(417) 820-5089
(417) 820-5085
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
63-10
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502721400
—
MO
01
—
CB9013
TRAVELERS/RR MEDICARE #
MO
Enumeration date
06/15/2006
Last updated
04/30/2025
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