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General NPI Number Information
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NPI Number | 1972620383
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Entity Type | Organization
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Legal Business Name | BRIDGES MEDICAL SERVICES P.C.
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 155 VILLAGE DR
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City | SPARTA
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State | MO
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Zip | 65753
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Country | US
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Telephone | 417-634-4203
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Fax | 417-634-4505
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Provider Business Mailing Address
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Address Line | PO BOX 1240
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City | FORSYTH
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State | MO
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Zip | 65653-1240
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Country | US
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Telephone | 417-546-4200
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Fax | 417-546-4505
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Authorized Official
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Title or Position | OWNER
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Name | DR. JANIECE RACHELLE BRIDGES
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Credential | M.D.
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Telephone | 417-546-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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