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Organization

FORDLAND CLINIC, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOAN TWITON (EXECUTIVE DIRECTOR)
(417) 767-2273
Entity
Organization

Contact information

Practice address
1059 BARTON DR, FORDLAND, MO 65652-7350
(417) 767-2273
(417) 767-4054
Mailing address
1059 BARTON DR, FORDLAND, MO 65652-7350
(417) 767-2273
(417) 767-4054

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
26-1009
MO
261QR1300X
Rural Health Clinic/Center
263865
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
508519105
MO
Enumeration date
08/14/2006
Last updated
06/19/2019
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