| Big Springs Medical Association | |
|
221 Co Rd 816 Black MO 63625 | |
| (537) 269-1035 | |
| (573) 269-1037 |
| Full Name | Big Springs Medical Association |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 221 Co Rd 816, Black, Missouri |
| Authorized Official Name and Position | Sherilyn Clark (CEO) |
| Authorized Official Contact | 5736632313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Big Springs Medical Association Po Box 157 Ellington MO 63638-0157 Ph: (537) 663-2313 | Big Springs Medical Association 221 Co Rd 816 Black MO 63625 Ph: (537) 269-1035 |
| NPI Number | 1184719064 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 07/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184719064 | NPI | - | NPPES |
| 509059002 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |