ST. JOHN'S CLINIC INC. NPI 1003187402

NPI Information

ST. JOHN'S CLINIC, INC. is a rural health clinic center in Nixa, MO. ST. JOHN'S CLINIC, INC. NPI is 1003187402. The provider is registered as an organization entity type.

The provider's business location address is:

940 W MOUNT VERNON ST
NIXA, MO
ZIP 65714-609
Phone: (417) 724-5437
Fax: (417) 724-5433

The provider's authorized official is Donn E. Sorensen .
The authorized official title is Vice President Ambulatory Care and has the following contact phone number (417) 820-6556.

The enumeration date for this NPI number is 1/18/2012 and was last updated on 1/18/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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