National Provider Identifier Database

MANSFIELD CLINIC INC
Rural Health


Contact Information

MANSFIELD CLINIC, INC.
120 SW 2ND AVENUE
AVA, MO65608
Phone: 417-683-6790
Fax: 417-683-6770
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for MANSFIELD CLINIC, INC.

NPI Number 1285687509
Legal business name
LBN
MANSFIELD CLINIC, INC.
Authorized official KENNETH DUGAN - (VICE PRESIDENT)
Entity Organization
Organization subpart Yes
Enumeration date 05/18/2006
Last updated 04/21/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • MO Medicaid: 508809506

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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