Healthcare Provider Details

I. General information

NPI: 1154656940
Provider Name (Legal Business Name): BRIDGES MEDICAL SERVICES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2009
Last Update Date: 11/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 STATE HIGHWAY 248 STE O
BRANSON MO
65616-9257
US

IV. Provider business mailing address

PO BOX 1240
FORSYTH MO
65653-1240
US

V. Phone/Fax

Practice location:
  • Phone: 417-239-0706
  • Fax: 417-239-0768
Mailing address:
  • Phone: 417-546-4200
  • Fax: 417-546-4505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HEATHER RENAE CULLER
Title or Position: OFFICE MANAGER
Credential:
Phone: 417-546-4200