MEDICARE: OZARKS MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center	174-47	MO

General Provider Information

NPI Number	:	1952472391
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OZARKS MEDICAL CENTER

Provider Business Mailing Address
First Line	:	PO BOX 1100
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-1100
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	308 DAVIS DR
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-2279
Country	:	US
Telephone Number	:	417-257-5911
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	PHILIP BAGBY
Credential	:
Telephone Number	:	417-256-9111

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	08/22/2020

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