Provider Demographics
NPI:1275730160
Name:BARTON COUNTY MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:BARTON COUNTY MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:T
Authorized Official - Middle Name:J
Authorized Official - Last Name:KILLINGSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-681-5248
Mailing Address - Street 1:29 NW 1ST LN
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:MO
Mailing Address - Zip Code:64759-8105
Mailing Address - Country:US
Mailing Address - Phone:417-681-5284
Mailing Address - Fax:417-681-5514
Practice Address - Street 1:29 NW 1ST LN
Practice Address - Street 2:
Practice Address - City:LAMAR
Practice Address - State:MO
Practice Address - Zip Code:64759-8105
Practice Address - Country:US
Practice Address - Phone:417-681-5284
Practice Address - Fax:417-681-5514
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BARTON COUNTY MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-02
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101370207Q00000X
MOR3B59207RR0500X
MO114482207RR0500X
MO105928207V00000X
MO106158207V00000X
MO1003032084N0400X
MO268648261QR1300X
MOF0497088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1184660995OtherCHRISTOPHER R ANDREWS MD
MO1235169723Medicaid
1538182639OtherJUSTIN S OGDEN MD
MO1689717456OtherTHOMAS A HOPKINS MD
1194051433OtherTIFFANY HUFFMAN FNP
MO1275730160Medicaid
MO1013955541OtherMARK JAREK MD
MO1013010370OtherMICHELLE A BOICE MD
MO1083614291OtherDAVID E BROWN, DO
MO268648OtherRURAL HEALTH CLINIC PROVIDER NUMBER
MO6601360001OtherDMEPOS
1174555957OtherLARRY K MIDYETT
1194051433OtherNPI
MO1235169723OtherJOSEPH F WILSON, DO
MO1972546802OtherRICHARD G KENNEY DO
MO1710063078Medicaid
MO1083614291Medicaid
MO1407959760OtherBRETT E BOICE DO
1669416046OtherANTHONY T TAY MD
MO1710063078OtherJOHN E ALDEN DO
1174555957OtherLARRY K MIDYETT
1194051433OtherNPI
MO1235169723Medicare PIN
MO1083614291Medicare PIN
MO1689717456OtherTHOMAS A HOPKINS MD
MOE69067Medicare UPIN
MO1275730160Medicare PIN
MO1871532283Medicare PIN
1184660995OtherCHRISTOPHER R ANDREWS MD
1194051433OtherTIFFANY HUFFMAN FNP
MO1013955541OtherMARK JAREK MD
MO1013010370OtherMICHELLE A BOICE MD
MO1710063078Medicaid
MO1710063078Medicare PIN