Dr Geetha G Herath, MD | |
54 Hospital Dr, Osage Beach, MO 65065-3050 | |
(573) 348-8000 | |
(573) 348-8069 |
Full Name | Dr Geetha G Herath |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 54 Hospital Dr, Osage Beach, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730104183 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 106038 (Missouri) | Primary |
207P00000X | Emergency Medicine | 106038 (Missouri) | Secondary |
Entity Name | Southeastern Emergency Physicians Of Memphis Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1437105277 PECOS PAC ID: 5395643209 Enrollment ID: O20060711000434 |
Mailing Address | Practice Location Address |
---|---|
Dr Geetha G Herath, MD 54 Hospital Dr, Osage Beach, MO 65065-3050 Ph: (573) 348-8000 | Dr Geetha G Herath, MD 54 Hospital Dr, Osage Beach, MO 65065-3050 Ph: (573) 348-8000 |
Dr. Trent K Russell, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1057 Medical Park Dr, Suite A, Osage Beach, MO 65065 Phone: 573-348-2745 Fax: 573-348-8279 | |
Dr. Maria E. Bernabe, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 931 Highway D, Osage Beach, MO 65065 Phone: 573-392-5606 | |
Dr. Whitney L. Cline, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 3870 Columbia Ave, Osage Beach, MO 65065 Phone: 573-302-7490 | |
Jacqueline E Santamarina, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 54 Hospital Dr, Osage Beach, MO 65065 Phone: 573-302-2287 Fax: 573-302-2241 | |
Parker Trent Russell, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 54 Hospital Dr, Osage Beach, MO 65065 Phone: 573-302-2287 Fax: 573-302-2241 | |
Kristen Anne Theobald-hazel, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1057 Medical Park Dr, Osage Beach, MO 65065 Phone: 573-302-3100 Fax: 573-348-8279 |