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2238 W Kingsley St Springfield MO 65807-5456 | |
(417) 831-0150 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 2238 W Kingsley St, Springfield, Missouri |
Authorized Official Name and Position | Jo Anne Thompson (DIRECTOR OF FINANCE) |
Authorized Official Contact | 4178511551 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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440 E Tampa St Springfield MO 65806-1131 Ph: (417) 831-0150 | 2238 W Kingsley St Springfield MO 65807-5456 Ph: (417) 831-0150 |
NPI Number | 1407490741 |
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Provider Enumeration Date | 10/30/2019 |
Last Update Date | 12/02/2021 |
Medicare PECOS PAC ID | 5395653562 |
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Medicare Enrollment ID | O20191203000784 |
Identifier | Type | State | Issuer |
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1407490741 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
James M. Carmichael, Dc Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3108 S Fremont Ave, Springfield, MO 65804 Phone: 417-886-4910 Fax: 417-886-4910 | |
Mercy Clinic Hospitalists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2600 Fax: 417-820-2100 | |