| |
75 Smithson Suite A Cassville MO 65625-9429 | |
(417) 847-3500 | |
(417) 847-3523 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 75 Smithson, Cassville, Missouri |
Authorized Official Name and Position | Jeffrey Hawkins (VP OF OPERATIONS) |
Authorized Official Contact | 4172696263 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 505673 Saint Louis MO 63150-5673 Ph: (417) 730-6430 | 75 Smithson Suite A Cassville MO 65625-9429 Ph: (417) 847-3500 |
NPI Number | 1619030681 |
---|---|
Provider Enumeration Date | 12/19/2006 |
Last Update Date | 09/30/2024 |
Medicare PECOS PAC ID | 0345236667 |
---|---|
Medicare Enrollment ID | O20040622000817 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619030681 | NPI | - | NPPES |
598869105 | Medicaid | MO | |
506856400 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Barry County Health Department Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 65 Main St, Cassville, MO 65625 Phone: 417-847-2114 Fax: 417-847-2116 |