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Organization

MERCY CLINIC-SPRINGFIELD COMMUNITIES

Active
Other names
Mercy Clinic Family Medicine - Rolla
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT CAVAGNOL (CHIEF PHYSICIAN OFFICER)
(417) 820-2705
Entity
Organization

Contact information

Practice address
1605 MARTIN SPRINGS DR STE 210, ROLLA, MO 65401-3028
(573) 458-6350
(573) 458-6764
Mailing address
645 MARYVILLE CENTRE DR FL 3, SAINT LOUIS, MO 63141-5855
(417) 820-7133
(417) 820-0586

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R5474
MO
261QR1300X
Rural Health Clinic/Center
Primary
MO
363LF0000X
Family Nurse Practitioner
064070
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
595684804
MO
Enumeration date
03/09/2007
Last updated
12/04/2018
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