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General NPI Number Information
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NPI Number | 1548780620
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Entity Type | Organization
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Legal Business Name | SKAGGS COMMUNITY HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 1150 STATE HIGHWAY 248 STE 102
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City | BRANSON
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State | MO
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Zip | 65616-4186
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Country | US
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Telephone | 417-269-7241
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4046
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City | SPRINGFIELD
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State | MO
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Zip | 65808-4046
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Country | US
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Telephone | 417-269-7241
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Fax | 417-269-7567
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Authorized Official
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Title or Position | CEO
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Name | WILLIAM K MAHONEY
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Credential |
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Telephone | 417-335-7270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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