Provider Demographics
NPI: | 1477719284 |
---|---|
Name: | LANDMARK HOSPITAL OF JOPLIN, LLC |
Entity Type: | Organization |
Organization Name: | LANDMARK HOSPITAL OF JOPLIN, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | STEVE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SPENCE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 417-627-1301 |
Mailing Address - Street 1: | 2040 W 32ND ST |
Mailing Address - Street 2: | |
Mailing Address - City: | JOPLIN |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 64804-3512 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2040 W 32ND ST |
Practice Address - Street 2: | |
Practice Address - City: | JOPLIN |
Practice Address - State: | MO |
Practice Address - Zip Code: | 64804-3512 |
Practice Address - Country: | US |
Practice Address - Phone: | 417-627-1300 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-07-31 |
Last Update Date: | 2008-07-31 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |