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General NPI Number Information
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NPI Number | 1891478301
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Entity Type | Organization
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Legal Business Name | OZARKS MEDICAL CENTER
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 500 E 19TH ST STE C
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City | MOUNTAIN GROVE
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State | MO
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Zip | 65711-1115
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Country | US
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Telephone | 417-926-6563
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Fax | 417-926-0911
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Provider Business Mailing Address
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Address Line | PO BOX 1100
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City | WEST PLAINS
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State | MO
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Zip | 65775-1100
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Country | US
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Telephone | 417-256-9111
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Fax | 417-257-5814
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MELODY SIMPSON
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Credential |
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Telephone | 417-853-5293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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