Provider Demographics
NPI:1083828743
Name:PARKVIEW ORTHOPAEDIC CLINIC
Entity Type:Organization
Organization Name:PARKVIEW ORTHOPAEDIC CLINIC
Other - Org Name:CITIZENS MEMORIAL HEALTHCARE CLINICS
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTMARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-328-6545
Mailing Address - Street 1:1245 N BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-3017
Mailing Address - Country:US
Mailing Address - Phone:417-777-2663
Mailing Address - Fax:
Practice Address - Street 1:1245 N BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-3017
Practice Address - Country:US
Practice Address - Phone:417-777-2663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty