Dr Philip R Brackett, DO | |
1333 S Sam Houston Blvd, Houston, MO 65483-2046 | |
(417) 967-3311 | |
(417) 967-3764 |
Full Name | Dr Philip R Brackett |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 1333 S Sam Houston Blvd, Houston, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396792453 | NPI | - | NPPES |
26-8630 | Other | MO | RH MEDICARE |
1447412770 | Other | MO | RH MEDICAID (CLINIC) |
240293274 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 29720 (Missouri) | Primary |
Entity Name | Fulton Medical Center Llc |
---|---|
Entity Type | Part B Supplier - Hospital Department(s) |
Entity Identifiers | NPI Number: 1417367665 PECOS PAC ID: 7810211398 Enrollment ID: O20150123001617 |
Mailing Address | Practice Location Address |
---|---|
Dr Philip R Brackett, DO 1333 S Sam Houston Blvd, Houston, MO 65483-2046 Ph: (417) 967-3311 | Dr Philip R Brackett, DO 1333 S Sam Houston Blvd, Houston, MO 65483-2046 Ph: (417) 967-3311 |
Dr. Kristina R Grant, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 1337 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-5435 Fax: 417-967-5503 | |
Dr. William Ryan Errico, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 1337 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-5435 Fax: 417-967-5503 | |
Dr. William C. Wright, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1337 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-5639 Fax: 417-967-5667 | |
Dr. Donald P. Schaefer Jr., D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 1333 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-3311 Fax: 417-967-1234 | |
David W Dale, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1340 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-3755 Fax: 417-967-2630 | |
Dr. Lynn D. Hauenstein, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1333 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-3311 Fax: 417-967-3764 |