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General NPI Number Information
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NPI Number | 1053350454
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Entity Type | Organization
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Legal Business Name | MERCY CLINIC SPRINGFIELD COMMUNITIES
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 290 CLIFT CT
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City | HOLLISTER
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State | MO
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Zip | 65672-5947
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Country | US
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Telephone | 417-829-4620
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Fax | 417-829-4316
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Provider Business Mailing Address
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Address Line | PO BOX 2580
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City | SPRINGFIELD
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State | MO
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Zip | 65801-2580
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Country | US
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Telephone | 417-829-4620
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | BJ ROBERTS
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Credential |
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Telephone | 417-820-7363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T03477
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | T03477
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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