Organization
BOTHWELL REGIONAL HEALTH CENTER
Active
Other names
BRH Ear Nose & Throat, Bothwell Eldenburg Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
LORI WIGHTMAN (CEO)
(660) 827-9481
Entity
Organization
Contact information
Practice address
700 S HANCOCK AVE, SEDALIA, MO 65301-4638
(660) 827-7998
(660) 829-8679
Mailing address
PO BOX 801128, KANSAS CITY, MO 64180-1128
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47681077
BC BS OF KC
—
01
—
CK7172
MEDICARE RR
—
05
—
PENDING
—
MO
Enumeration date
06/01/2012
Last updated
05/14/2026
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