Dr Randy Agolia, MD | |
20 Progress Point Pkwy, Ste 22, O Fallon, MO 63368-2206 | |
(636) 344-3333 | |
(636) 344-3334 |
Full Name | Dr Randy Agolia |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 20 Progress Point Pkwy, O Fallon, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972575439 | NPI | - | NPPES |
200026270 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 108370 (Missouri) | Primary |
Entity Name | Wuca-o'fallon Pediatrics Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366830572 PECOS PAC ID: 0941512453 Enrollment ID: O20150710001960 |
Mailing Address | Practice Location Address |
---|---|
Dr Randy Agolia, MD Po Box 505436, Saint Louis, MO 63150-5436 Ph: (636) 344-3333 | Dr Randy Agolia, MD 20 Progress Point Pkwy, Ste 22, O Fallon, MO 63368-2206 Ph: (636) 344-3333 |
Dr. Cecilia H Yu, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 20 Progress Point Pkwy, Ste 22, O Fallon, MO 63368 Phone: 636-344-3333 Fax: 636-344-3334 | |
Kimberly N Hackney, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Winding Woods Dr Ste 120, O Fallon, MO 63366 Phone: 636-978-7902 | |
Dr. Yasangi Marina Jayasinha, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1001 Highway K, Suite 4, O Fallon, MO 63366 Phone: 636-240-9896 | |
Dr. John A Myers, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 20 Progress Point Pkwy, Ste 22, O Fallon, MO 63368 Phone: 636-344-3333 Fax: 636-344-3334 | |
Dr. Trina J Blythe, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 20 Progress Point Pkwy Ste 100, O Fallon, MO 63368 Phone: 636-344-2213 | |
Dr. Phillip D Reichert, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 20 Progress Point Pkwy, Ste 22, O Fallon, MO 63368 Phone: 636-344-3333 Fax: 636-344-3334 | |
Melissa Roewe, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 9979 Winghaven Blvd Ste 206, O Fallon, MO 63368 Phone: 636-561-5291 Fax: 636-561-5290 |