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NPI Code Detail

MEDICARE: OZARKS MEDICAL CENTER

MEDICARE: OZARKS MEDICAL CENTER
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
1261QR1300XRural Health Clinic/Center17447MO

Other Identifiers

General Provider Information

NPI Number : 1649306002
Entity Type Code : Organization
Provider Name (Legal Business Name) : OZARKS MEDICAL CENTER
Provider Business Mailing Address
First Line : PO BOX 250
Second Line :
City : MAMMOTH SPRING
State : AR
Zip : 72554-0250
Country : US
Telephone Number : 870-625-3228
Fax Number : 870-625-3227
Provider Business Practice Location Address
First Line : 260 S MAIN STREET
Second Line :
City : MAMMOTH SPRING
State : AR
Zip : 72554-7466
Country : US
Telephone Number : 870-625-3228
Fax Number : 870-625-3227
Authorized Official
Title or Position : PRESIDENT AND CEO
Name : THOMAS KELLER
Credential :
Telephone Number : 417-256-9111
Provider Enumeration Date : 02/27/2007
Last Update Date : 11/12/2020

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Directions to “OZARKS MEDICAL CENTER ” Practice Location

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