| Mercy Clinic Family Medicine-mountain Grove | |
|
120 W 16th St Mountain Grove MO 65711 | |
| (417) 926-6111 | |
| (417) 926-6115 |
| Full Name | Mercy Clinic Family Medicine-mountain Grove |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 W 16th St, Mountain Grove, Missouri |
| Authorized Official Name and Position | Robert Cavagnol (CHIEF PHYSICIAN OFFICER) |
| Authorized Official Contact | 4178202705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Clinic Family Medicine-mountain Grove 645 Maryville Centre Dr Fl 3 Saint Louis MO 63141-5855 Ph: (417) 820-7133 | Mercy Clinic Family Medicine-mountain Grove 120 W 16th St Mountain Grove MO 65711 Ph: (417) 926-6111 |
| NPI Number | 1457480188 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 12/04/2018 |
| Medicare PECOS PAC ID | 7416865845 |
|---|---|
| Medicare Enrollment ID | O20081029000377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457480188 | NPI | - | NPPES |
| 597932300 | Medicaid | MO |
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