| Mercy Clinic Pediatrics-rolla | |
|
1605 Martin Springs Dr Suite 250 Rolla MO 65401 | |
| (573) 458-6363 | |
| (573) 458-6765 |
| Full Name | Mercy Clinic Pediatrics-rolla |
|---|---|
| Speciality | Clinic/Center |
| Location | 1605 Martin Springs Dr, Rolla, Missouri |
| Authorized Official Name and Position | William J Roberts (CFO) |
| Authorized Official Contact | 4178207363 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Clinic Pediatrics-rolla 1605 Martin Springs Dr Ste 250 Rolla MO 65401-2980 Ph: (417) 820-7133 | Mercy Clinic Pediatrics-rolla 1605 Martin Springs Dr Suite 250 Rolla MO 65401 Ph: (573) 458-6363 |
| NPI Number | 1922137645 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 10/14/2025 |
| Certification Date | 10/14/2025 |
| Medicare PECOS PAC ID | 7416865845 |
|---|---|
| Medicare Enrollment ID | O20041215000227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922137645 | NPI | - | NPPES |
| 597380708 | Medicaid | MO |
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