Organization Name:  WEST PLAINS SURGERY CENTER LLC


Practice Location:
1401 DOCTORS DR  WEST PLAINS, MO 65775 US
Tel: 417-256-1400  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	261QA1903X	Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical	MO	160-0

Other Provider Identifiers:

Issuer	Number	State	Type
STATE LICENSE	160-0	MO	01
MEDICARE PTAN	000040088	MO	01
	507268902	MO	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin