Organization
MERCY CLINIC SPRINGFIELD COMMUNITIES
Active
Other names
Mercy Clinic Pediatrics- Lebanon
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM ROBERTS (VICE PRESIDENT FINANCE)
(417) 820-7363
Entity
Organization
Contact information
Practice address
120 HOSPITAL DR STE 350, LEBANON, MO 65536-9253
(417) 533-6746
(417) 533-6740
Mailing address
1570 W BATTLEFIELD ST STE 110, SPRINGFIELD, MO 65807-4163
(417) 820-7133
(417) 820-0586
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
MO
363LF0000X
Family Nurse Practitioner
123516
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
597785609
—
MO
Enumeration date
03/05/2007
Last updated
10/14/2020
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