Healthcare Provider Details

I. General information

NPI: 1295815017
Provider Name (Legal Business Name): OZARKS MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 11/12/2020
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 N ELM STREET
MT. VIEW MO
65548-7109
US

IV. Provider business mailing address

PO BOX 32
MOUNTAIN VIEW MO
65548-0032
US

V. Phone/Fax

Practice location:
  • Phone: 417-296-6563
  • Fax: 417-926-5820
Mailing address:
  • Phone: 417-934-2273
  • Fax: 417-934-2332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. THOMAS W. KELLER
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 417-256-9111