Organization
OZARKS MEDICAL CENTER
Active
Other names
OMC BHC MH Crisis Prevention Project
Organization subpart
No
Provider details
NPI number
Authorized official
BARRYLYN SOUNDARARAJAN (PROVIDER ENROLLMENT COORDINATOR)
(417) 257-8752
Entity
Organization
Contact information
Practice address
1211 PORTER WAGONER BLVD # 23, WEST PLAINS, MO 65775-1826
(417) 257-6762
(417) 257-5875
Mailing address
PO BOX 1100, WEST PLAINS, MO 65775-1100
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
174-57
MO
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/15/2016
Last updated
04/15/2016
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