Organization
VALLEY MEDICAL CENTER P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM E BERNER (CLINIC ADMINISTRATOR)
(989) 892-7722
Entity
Organization
Contact information
Practice address
308 S HARRIS ST, WILLOW SPRINGS, MO 65793-1621
(417) 469-3175
(417) 469-1274
Mailing address
308 S HARRIS ST, WILLOW SPRINGS, MO 65793-1621
(417) 469-3175
(989) 892-7455
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112904
BLUE CROSS
MO
01
—
205784
BLUE CROSS
MO
01
—
263871
CAHABA GBA
—
05
—
598649408
—
MO
01
—
P00163042
RAIL ROAD MEDICARE
—
Enumeration date
06/17/2006
Last updated
08/20/2014
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