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General NPI Number Information
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NPI Number | 1548401896
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Entity Type | Organization
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Legal Business Name | BOTHWELL REGIONAL HEALTH CENTER
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Dates
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Enumeration Date | 03/17/2009
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Last Update Date | 03/29/2014
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Provider Practice Location Address
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Address Line | 600 EAST 12TH ST
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City | SEDALIA
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State | MO
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Zip | 65301
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Country | US
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Telephone | 660-827-9573
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Fax | 660-829-6606
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Provider Business Mailing Address
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Address Line | PO BOX 1706 601 E 14TH STREET
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City | SEDALIA
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State | MO
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Zip | 65302-1706
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Country | US
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Telephone | 660-826-8833
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Fax | 660-827-3742
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Authorized Official
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Title or Position | CFO
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Name | JAMES A ROBERTSON
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Credential |
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Telephone | 660-827-9482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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