| Mercy Diabetes Prevention - Springfield | |
|
1965 S Fremont Ave Ste 200 Springfield MO 65804-2283 | |
| (417) 820-7233 | |
| Not Available |
| Full Name | Mercy Diabetes Prevention - Springfield |
|---|---|
| Speciality | Internal Medicine |
| Location | 1965 S Fremont Ave Ste 200, Springfield, Missouri |
| Authorized Official Name and Position | BJ 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 Diabetes Prevention - Springfield Po Box 776084 Chicago IL 60677-6084 | Mercy Diabetes Prevention - Springfield 1965 S Fremont Ave Ste 200 Springfield MO 65804-2283 Ph: (417) 820-7233 |
| NPI Number | 1366152407 |
|---|---|
| Provider Enumeration Date | 11/30/2022 |
| Last Update Date | 04/30/2025 |
| Certification Date | 04/30/2025 |
| Medicare PECOS PAC ID | 7416865845 |
|---|---|
| Medicare Enrollment ID | O20230214000267 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366152407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | () | Primary |
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