Amanda M Ryden, MD | |
405 W Jackson St, Carbondale, IL 62901-1462 | |
(618) 549-0721 | |
(618) 457-0469 |
Full Name | Amanda M Ryden |
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Gender | Female |
Speciality | Emergency Medicine |
Location | 405 W Jackson St, Carbondale, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033223359 | NPI | - | NPPES |
200445280 | Medicaid | IN | |
64062599 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 37787 (Kentucky) | Secondary |
207P00000X | Emergency Medicine | 42040 (Tennessee) | Secondary |
207P00000X | Emergency Medicine | 036143926 (Illinois) | Primary |
Entity Name | Baptist Health Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740586213 PECOS PAC ID: 5597867184 Enrollment ID: O20070228000503 |
Mailing Address | Practice Location Address |
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Amanda M Ryden, MD Po Box 1467, Indianapolis, IN 46206-1467 Ph: (618) 457-5200 | Amanda M Ryden, MD 405 W Jackson St, Carbondale, IL 62901-1462 Ph: (618) 549-0721 |
Scott A. Cooper, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 405 W Jackson St, Memorial Hospital, Carbondale, IL 62901 Phone: 618-549-0721 Fax: 618-529-0449 | |
Ethan Mark Huckabee, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 405 W Jackson St, Carbondale, IL 62901 Phone: 618-549-0721 | |
Connor Stephenson, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 405 W Jackson St, Carbondale, IL 62901 Phone: 618-549-0721 Fax: 618-457-0469 | |
Dr. Osama Aaflaq, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 405 W Jackson St, Carbondale, IL 62901 Phone: 618-549-0721 | |
Kevin M Martin, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 405 W Jackson St, Carbondale, IL 62901 Phone: 618-549-0721 Fax: 618-457-0469 | |
James Sullivan, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 405 W Jackson St, Carbondale, IL 62901 Phone: 618-549-0721 Fax: 618-457-0469 |