Healthcare Provider Details

I. General information

NPI: 1346352606
Provider Name (Legal Business Name): SKAGGS COMMUNITY HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 BRANSON HILLS PKWY STE 110
BRANSON MO
65616-9908
US

IV. Provider business mailing address

PO BOX 7411606
CHICAGO IL
60674-5626
US

V. Phone/Fax

Practice location:
  • Phone: 417-348-8990
  • Fax: 417-348-8090
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM K MAHONEY
Title or Position: CEO
Credential:
Phone: 417-335-7270