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General NPI Number Information
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NPI Number | 1407913676
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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 | 01/03/2007
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Last Update Date | 02/07/2012
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Provider Practice Location Address
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Address Line | 3231 S NATIONAL AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65807-7304
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Country | US
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Telephone | 417-883-7422
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Fax |
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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 | 417-829-4316
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | DONN SORENSEN
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Credential |
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Telephone | 417-829-4264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T002235
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 105723
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | R8F16
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R3B79
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License Number State | MO
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Taxonomy #5
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | R9348
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License Number State | MO
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Taxonomy #6
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | R8331
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License Number State | MO
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Taxonomy #7
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 108358
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License Number State | MO
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Taxonomy #8
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | R5004
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License Number State | MO
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Taxonomy #9
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 102991
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License Number State | MO
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