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General NPI Number Information
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NPI Number | 1871522904
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Entity Type | Organization
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Legal Business Name | SKAGGS COMMUNITY HOSPTIAL ASSOCIATION
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 101 SKAGGS RD MEDICAL PLAZA 1 STE 403
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City | BRANSON
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State | MO
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Zip | 65616
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Country | US
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Telephone | 417-348-8105
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Fax | 417-348-8107
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Provider Business Mailing Address
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Address Line | 101 SKAGGS RD MEDICAL PLAZA 1 STE 403
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City | BRANSON
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State | MO
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Zip | 65616
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Country | US
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Telephone | 417-348-8105
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Fax | 417-348-8107
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Authorized Official
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Title or Position | CEO
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Name | STEPHEN M ERIXON
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Credential |
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Telephone | 417-335-7350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 5248
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License Number State | MO
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