Susan Buckallew, | |
1101 Jamison St, Kirksville, MO 63501-3943 | |
(660) 665-1962 | |
(660) 627-0642 |
Full Name | Susan Buckallew |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 1101 Jamison St, Kirksville, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386952604 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | 2010032751 (Missouri) | Secondary |
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Entity Name | Preferred Family Healthcare, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649474206 PECOS PAC ID: 0244256246 Enrollment ID: O20051019000599 |
Mailing Address | Practice Location Address |
---|---|
Susan Buckallew, 1101 Jamison St, Kirksville, MO 63501-3943 Ph: (660) 665-1962 | Susan Buckallew, 1101 Jamison St, Kirksville, MO 63501-3943 Ph: (660) 665-1962 |
Brenna Newberry, PLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 900 E Laharpe St, Kirksville, MO 63501 Phone: 660-665-1962 | |
Joseph Cox, Counselor Medicare: Medicare Enrolled Practice Location: 900 E Laharpe St, Kirksville, MO 63501 Phone: 660-665-1962 | |
Summer M. Nelson, PLPC Counselor Medicare: Medicare Enrolled Practice Location: 900 E Laharpe St, Kirksville, MO 63501 Phone: 660-665-1962 | |
Eric D Braaten, RASAC I Counselor Medicare: Not Enrolled in Medicare Practice Location: 1101 Jamison St, Kirksville, MO 63501 Phone: 660-665-1962 Fax: 660-627-0642 | |
Krysten Jolynn Jarman, Counselor Medicare: Medicare Enrolled Practice Location: 1101 Jamison St, Kirksville, MO 63501 Phone: 660-474-0267 | |
Kourtney Buckallew, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1101 Jamison St, Kirksville, MO 63501 Phone: 660-665-1962 | |
Mr. Lucas Charles Fischer, MED Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 E Normal Ave, Kirksville, MO 63501 Phone: 660-785-4014 Fax: 660-785-4011 |