Healthcare Provider Details

I. General information

NPI: 1871291765
Provider Name (Legal Business Name): BOTHWELL REGIONAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 US 65 HWY
LINCOLN MO
65338
US

IV. Provider business mailing address

PO BOX 801128
KANSAS CITY MO
64180-1128
US

V. Phone/Fax

Practice location:
  • Phone: 660-547-3915
  • Fax: 660-547-3019
Mailing address:
  • Phone: 660-547-3915
  • Fax: 660-547-3019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LORI WIGHTMAN
Title or Position: CEO
Credential:
Phone: 660-827-9481