Provider Demographics
NPI:1427256007
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:BUSINESS 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:417-232-5200
Mailing Address - Street 1:723 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOCKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:65682-0301
Mailing Address - Country:US
Mailing Address - Phone:417-232-5200
Mailing Address - Fax:417-232-5220
Practice Address - Street 1:723 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LOCKWOOD
Practice Address - State:MO
Practice Address - Zip Code:65682-0301
Practice Address - Country:US
Practice Address - Phone:417-232-5200
Practice Address - Fax:417-232-5220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101370207Q00000X
MO105928207V00000X
MO106158207V00000X
MO268624261QR1300X
MOF0497088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1184881090Medicaid
MO1689717456OtherTHOMAS A HOPKINS MD
MO1427256007Medicaid
MO1013010370OtherMICHELLE ADRIANA BOICE M.D.
MO1497962260OtherDEBBIE JOHNSON FNP
MO540421401Medicaid
MO1104801547Medicaid
MO1427256007Medicare PIN
MO1104801547Medicaid
MO26-8624Medicare PIN
MO268624Medicare PIN