Organization
SKAGGS COMMUNITY HOSPITAL ASSOCIATION
Active
Other names
Skaggs Plastic & Reconstructive Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
LISA L PENNETTA (MEDICAL STAFF SERVICES)
(417) 335-7490
Entity
Organization
Contact information
Practice address
121 CAHILL RD, SUITE 205, BRANSON, MO 65616-2036
(417) 334-8253
(417) 337-8992
Mailing address
121 CAHILL RD, SUITE 205, BRANSON, MO 65616-2036
(417) 334-8253
(417) 337-8992
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
52-53
MO
Other
Enumeration date
12/22/2010
Last updated
12/22/2010
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