NPI 1053760769

Mountain Grove Medical and Laser Center INC

Organisation General Practice Physician Mountain Grove, MO

Practice location

Address: 601 N Busch Ave, Mountain Grove, MO 65711
Phone: (417) 926-6643
Fax: (417) 926-6317
Mailing address: 1003 Woodside Ave, Essexville, MI 48732-1234

Authorised official

Name: Doyle B Hill
Title: Owner
Phone: (417) 926-6643

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

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Registry record

NPI: 1053760769
Entity type: Organization
NPI issued: 3 Jun 2016
Record last updated: 14 May 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.