Organization
BURTON CREEK RURAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THERESA CHRISTINE GREGG MHA (ADMINISTRATOR)
(417) 256-2111
Entity
Organization
Contact information
Practice address
805 KENTUCKY AVE, WEST PLAINS, MO 65775
(417) 256-2111
(417) 256-4858
Mailing address
805 N KENTUCKY AVE, WEST PLAINS, MO 65775-2022
(417) 256-2111
(417) 256-4858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
509022307
—
MO
05
—
599022308
—
MO
01
—
DC9179
MEDICARE RR
—
Enumeration date
09/30/2005
Last updated
02/05/2026
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