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General NPI Number Information
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NPI Number | 1740226091
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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 | 06/22/2006
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 207 CARTER ST
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City | BERRYVILLE
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State | AR
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Zip | 72616-4303
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Country | US
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Telephone | 870-423-6661
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Fax | 870-423-4374
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Provider Business Mailing Address
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Address Line | PO BOX 505164
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City | SAINT LOUIS
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State | MO
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Zip | 63150-5164
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R6D08
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License Number State | AR
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