Provider Demographics
NPI:1316193394
Name:OZARK FAMILY MEDICAL WALK-IN CLINICS, INC
Entity Type:Organization
Organization Name:OZARK FAMILY MEDICAL WALK-IN CLINICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:417-890-5550
Mailing Address - Street 1:4049 S CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5303
Mailing Address - Country:US
Mailing Address - Phone:417-890-5550
Mailing Address - Fax:417-889-6898
Practice Address - Street 1:4049 S CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5303
Practice Address - Country:US
Practice Address - Phone:417-890-5550
Practice Address - Fax:417-889-6898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-11
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO268982Medicare Oscar/Certification