Healthcare Provider Details

I. General information

NPI: 1477941862
Provider Name (Legal Business Name): SKAGGS COMMUNITY HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2015
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 BRANSON LANDING BLVD STE 201A
BRANSON MO
65616-2052
US

IV. Provider business mailing address

PO BOX 7411626
CHICAGO IL
60674-5626
US

V. Phone/Fax

Practice location:
  • Phone: 417-335-7128
  • Fax: 417-348-8007
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

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