Healthcare Provider Details

I. General information

NPI: 1811891542
Provider Name (Legal Business Name): SKAGGS COMMUNITY HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 S PAYNE STEWART DR STE 201
BRANSON MO
65616-2732
US

IV. Provider business mailing address

PO BOX 7411626
CHICAGO IL
60674-5626
US

V. Phone/Fax

Practice location:
  • Phone: 417-335-3636
  • Fax: 417-335-3626
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number StateNULL

VIII. Authorized Official

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