Dr Susan Pancoast Eddleman, DDS is a medicare enrolled "Dentist - General Practice" provider in Rock Port, Missouri. Her current practice location is
204 S Main St, Rock Port, Missouri. You can reach out to her office (for appointments etc.) via phone at
(660) 744-5391.
Dr Susan Pancoast Eddleman is licensed to practice in Missouri (license number 14169) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1184610909.
Healthcare Provider's Profile
Full Name | Dr Susan Pancoast Eddleman |
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Gender | Female |
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Speciality | Dentist - General Practice |
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Location | 204 S Main St, Rock Port, Missouri |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1184610909
- Provider Enumeration Date: 09/27/2005
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 7214247881
- Enrollment ID: I20151111000688
Medical Identifiers
Medical identifiers for Dr Susan Pancoast Eddleman such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1184610909 | NPI | - | NPPES |
13627011 | Other | MO | BCBS OF KANSAS CITY |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 14169 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Susan Pancoast Eddleman is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Susan Pancoast Eddleman, DDS 204 S Main St, P. O. Box 282, Rock Port, MO 64482-1532 Ph: (660) 744-5391 | Dr Susan Pancoast Eddleman, DDS 204 S Main St, Rock Port, MO 64482-1532 Ph: (660) 744-5391 |
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