Organization Name: | BIG SPRINGS MEDICAL ASSOCIATION |
NPI Number: | 1225045321 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHERILYN CLARK (CEO) |
Mailing Address: | 405 Main Street Van Buren |
State: | MO US |
Postal Code: | 639650486 |
Phone Number: | 5733234253 |
Fax Number: | 5733234465 |
NPI Enumeration Date: | 08/02/2006 |
NPI Last Update Date: | 07/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |