Mountain Grove Medical and Laser Center Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MOUNTAIN GROVE MEDICAL AND LASER CENTER INC

Practice address

601 N Busch Ave
Mountain Grove, MO 65711

Phone

(417) 926-6643

Fax

(417) 926-6317

NPI assigned

Jun 3, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Doyle B Hill, DO

Title

Owner

Phone

(417) 926-6643

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526256000000",
    "number": "1053760769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 WOODSIDE AVE",
            "city": "ESSEXVILLE",
            "state": "MI",
            "postal_code": "487321234",
            "telephone_number": "989-892-7722",
            "fax_number": "989-892-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N BUSCH AVE",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "65711",
            "telephone_number": "417-926-6643",
            "fax_number": "417-926-6317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN GROVE MEDICAL AND LASER CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-03",
        "last_updated": "2018-05-14",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "DOYLE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-926-6643",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053760769",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Mills, PA-C
• Moore Family Eyecare, LLC
• Douglas Loran Moore, OD
• Jade Moore, APRN, FNP-C
• Mountain Grove 2 Inc (Autumn Oaks Caring Center)
• Mountain Grove Medical and Laser Center Inc
• Mountain Grove Pharmacy Inc (Mountain Grove Pharmacy)
• Mountain Grove R-III School District
• Ashley Myers, LMSW
• Laney Ness

• General Practice Physician in Mountain Grove, MO
• Providers in Mountain Grove, MO by specialty
• General Practice Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.