Organization
BRANSON CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN ALLISON (CEO)
(417) 239-0125
Entity
Organization
Contact information
Practice address
110 BUSINESS PARK DR STE A, BRANSON, MO 65616-7451
(417) 239-0125
(417) 239-0127
Mailing address
110 BUSINESS PARK DR STE A, BRANSON, MO 65616-7451
(417) 239-0125
(417) 239-0127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
198478
BLUE CROSS - ANTHEM
MO
05
—
507300903
—
MO
Enumeration date
02/21/2006
Last updated
12/05/2022
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