Diane C Lipscomb, MD | |
1235 E Cherokee St, Springfield, MO 65804-2203 | |
(417) 829-5400 | |
(417) 820-7129 |
Full Name | Diane C Lipscomb |
---|---|
Gender | Female |
Speciality | Pediatrics - Pediatric Critical Care Medicine |
Location | 1235 E Cherokee St, Springfield, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780677732 | NPI | - | NPPES |
1780677732 | Medicaid | MO | |
195052001 | Medicaid | AR | |
431560263 | Other | MO | TRICARE |
P01116103 | Other | MO | RR MCR |
200209400 A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0203X | Pediatrics - Pediatric Critical Care Medicine | 2012034747 (Missouri) | Primary |
Entity Name | Mercy Clinic Springfield Communities |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245277631 PECOS PAC ID: 7416865845 Enrollment ID: O20031104000060 |
Mailing Address | Practice Location Address |
---|---|
Diane C Lipscomb, MD Po Box 2580, Springfield, MO 65801-2580 Ph: (417) 829-4620 | Diane C Lipscomb, MD 1235 E Cherokee St, Springfield, MO 65804-2203 Ph: (417) 829-5400 |
Dr. Alan Dare Tong, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 4350 S National Ave, Suite C 100, Springfield, MO 65810 Phone: 417-447-4700 Fax: 417-447-4701 | |
Michael Stephen Hanks, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1000 E Primrose, Ste 320, Springfield, MO 65807 Phone: 417-269-2300 Fax: 417-269-2315 | |
Matthew C Lundien, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1965 S Fremont Ave, Ste 220, Springfield, MO 65804 Phone: 417-820-9055 | |
Dr. Melinda Rae Slack, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-3219 | |
Brittany Nicole Montavon, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3801 S National Ave, Springfield, MO 65807 Phone: 417-269-6184 Fax: 417-269-4608 | |
Nicole Marie Kucera, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3443 S National Ave, Springfield, MO 65807 Phone: 417-269-2000 Fax: 417-269-2038 | |
James W Wilson, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3443 S National Ave, Springfield, MO 65807 Phone: 417-269-2000 Fax: 417-269-2038 |