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NPI Code Detail

MEDICARE: MERCY PHYSICIAN GROUP

MEDICARE: MERCY PHYSICIAN GROUP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center05-28424KS

General Provider Information

NPI Number : 1457344301
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCY PHYSICIAN GROUP
Provider Business Mailing Address
First Line : 403 WOODLAND HILLS BLVD
Second Line :
City : FORT SCOTT
State : KS
Zip : 66701-8798
Country : US
Telephone Number : 620-223-8040
Fax Number : 620-223-8524
Provider Business Practice Location Address
First Line : 403 WOODLAND HILLS BLVD
Second Line :
City : FORT SCOTT
State : KS
Zip : 66701-8798
Country : US
Telephone Number : 620-223-8040
Fax Number : 620-223-8524
Authorized Official
Title or Position : FAMILY PHYSICIAN
Name : MRS. SARA K RAGSDALE
Credential : D.O
Telephone Number : 620-223-8040
Provider Enumeration Date : 08/25/2005
Last Update Date : 08/22/2020

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Directions to “MERCY PHYSICIAN GROUP ” Practice Location

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