| Mercy Clinic Family Medicine-summersville | |
|
149 Rogers Ave Summersville MO 65571 | |
| (417) 932-4119 | |
| (417) 932-4838 |
| Full Name | Mercy Clinic Family Medicine-summersville |
|---|---|
| Speciality | Clinic/Center |
| Location | 149 Rogers Ave, Summersville, Missouri |
| Authorized Official Name and Position | William Roberts (CFO) |
| Authorized Official Contact | 4178207363 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Clinic Family Medicine-summersville 149 Rogers Ave Summersville MO 65571 Ph: (417) 820-7133 | Mercy Clinic Family Medicine-summersville 149 Rogers Ave Summersville MO 65571 Ph: (417) 932-4119 |
| NPI Number | 1053444000 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 07/21/2023 |
| Medicare PECOS PAC ID | 7416865845 |
|---|---|
| Medicare Enrollment ID | O20101209000623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053444000 | NPI | - | NPPES |
| 595813809 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | R7838 (Missouri) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (Missouri) | Primary |
Certified On-site Health Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 805 2nd St, Summersville, MO 65571 Phone: 417-932-1130 Fax: 417-932-1127 | |
Mercy Clinic-summersville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 149 Rogers Ave, Summersville, MO 65571 Phone: 417-932-4119 |