Organization
OZARK VALLEY MEDICAL CLINIC, LLC
Active
Parent organization
LIFT UP SOMEONE TODAY
Other names
Lift Up Someone Today
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFT UP SOMEONE TODAY
Authorized official
DR. PATRICIA ASHTON DERGES MD (CEO/OWNER)
(417) 317-5330
Entity
Organization
Contact information
Practice address
5571 N 21ST ST, OZARK, MO 65721-7488
(417) 317-5330
(417) 763-3370
Mailing address
5571 N 21ST ST, OZARK, MO 65721-7488
(417) 317-5330
(417) 763-3370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2017017409
MO
207Q00000X
Family Medicine Physician
2017024744
MO
207Q00000X
Family Medicine Physician
Primary
2017032792
MO
208VP0000X
Pain Medicine Physician
2017032792
MO
Other
Enumeration date
01/09/2018
Last updated
03/17/2018
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