| Fordland Clinic, Inc. | |
|
1300 E Bradford Pkwy Springfield MO 65804-4264 | |
| (417) 767-2273 | |
| Not Available |
| Full Name | Fordland Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1300 E Bradford Pkwy, Springfield, Missouri |
| Authorized Official Name and Position | Joan Twiton (CEO) |
| Authorized Official Contact | 4177672273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fordland Clinic, Inc. 1059 Barton Dr Fordland MO 65652-7350 Ph: (417) 767-2273 | Fordland Clinic, Inc. 1300 E Bradford Pkwy Springfield MO 65804-4264 Ph: (417) 767-2273 |
| NPI Number | 1386299501 |
|---|---|
| Provider Enumeration Date | 08/05/2019 |
| Last Update Date | 08/05/2019 |
| Medicare PECOS PAC ID | 5597794552 |
|---|---|
| Medicare Enrollment ID | O20190812001523 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386299501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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