St. John'S Physicians & Clinics, Inc.
Organization Active NPI Family Medicine Physician · Springfield, MO
NPI 1366486052 · NPPES record last updated Sep 22, 2008
Key facts
- NPI
- 1366486052
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ST. JOHN'S PHYSICIANS & CLINICS, INC.
- Practice address
- 620 S Glenstone Ave
St. John'S Physicians & Clinics, Inc.
Springfield, MO 65802-3206 - Phone
- (417) 829-4620
- Fax
- (417) 829-4316
- NPI assigned
- Jun 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Donn E. Sorensen
- Title
- Senior Vice President/Coo
- Phone
- (417) 820-6556
Corporate family (same tax ID) 24
Practitioners 2
-
Michael Marvin, M.D.
-
Milo Nelson Warner, D.O.
National Provider Directory
- Tax ID family
- Springfield Clinic Nucl
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
620 S Glenstone Ave
St. John'S Physicians & Clinics, Inc.
Springfield, MO 65802-3206
Mailing address
1965 S Fremont Ave
St. John'S Physicians & Clinics, Inc.
Springfield, MO 65804-2201
Phone (417) 829-4264
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 502606502 | Medicaid | MO |
Other providers in Springfield, MO
- Jay St. Amant
- St. John'S Health System
- St. John'S Health System
- St. John'S Physicians & Clinics, Inc.
- St. John'S Physicians & Clinics, Inc.
- St. John'S Physicians & Clinics, Inc.
- St. John'S Regional Health Center
- St. John'S Regional Health Center
- Adam St. Peter
- Katherine Julia St. Romain
All providers in Springfield, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.