Provider Demographics
NPI:1174693709
Name:REGIONAL SERVICES
Entity type:Organization
Organization Name:REGIONAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAX
Authorized Official - Middle Name:
Authorized Official - Last Name:BUETOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-631-0381
Mailing Address - Street 1:PO BOX 4046
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65808-4046
Mailing Address - Country:US
Mailing Address - Phone:417-269-5712
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:3525 S NATIONAL AVE
Practice Address - Street 2:#101
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-7310
Practice Address - Country:US
Practice Address - Phone:417-269-9950
Practice Address - Fax:417-269-9959
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LESTER E. COX MEDICAL CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-09
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty