| Mountain Grove Medical And Laser Center Inc | |
|
601 N Busch Ave Mountain Grove MO 65711 | |
| (417) 926-6643 | |
| (417) 926-6317 |
| Full Name | Mountain Grove Medical And Laser Center Inc |
|---|---|
| Speciality | General Practice |
| Location | 601 N Busch Ave, Mountain Grove, Missouri |
| Authorized Official Name and Position | Doyle B Hill (OWNER) |
| Authorized Official Contact | 4179266643 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Grove Medical And Laser Center Inc 1003 Woodside Ave Essexville MI 48732-1234 Ph: (989) 892-7722 | Mountain Grove Medical And Laser Center Inc 601 N Busch Ave Mountain Grove MO 65711 Ph: (417) 926-6643 |
| NPI Number | 1053760769 |
|---|---|
| Provider Enumeration Date | 06/03/2016 |
| Last Update Date | 05/14/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053760769 | NPI | - | NPPES |
| 1053760769 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |