Dustin Ross Mayne, DO | |
2900 Doolittle Dr, Ellsworth Afb, SD 57706 | |
(937) 641-3000 | |
(937) 641-5931 |
Full Name | Dustin Ross Mayne |
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Gender | Male |
Speciality | Pediatrics |
Location | 2900 Doolittle Dr, Ellsworth Afb, South Dakota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780045427 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 1780 (Nebraska) | Primary |
Entity Name | Memorial Hospital Of Converse County |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356496491 PECOS PAC ID: 2264340843 Enrollment ID: O20031203000672 |
Entity Name | Banner Hospital Based Physicians West Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619464120 PECOS PAC ID: 5799131579 Enrollment ID: O20231031001364 |
Mailing Address | Practice Location Address |
---|---|
Dustin Ross Mayne, DO 2900 Doolittle Dr, Ellsworth Afb, SD 57706-4821 Ph: (937) 641-3000 | Dustin Ross Mayne, DO 2900 Doolittle Dr, Ellsworth Afb, SD 57706 Ph: (937) 641-3000 |
Dr. Amy Costello, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2900 Doolittle Dr, Ellsworth Afb, SD 57706 Phone: 605-385-3285 | |
Dr. Caitlin Meyer, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2900 Doolittle Dr, Ellsworth Afb, SD 57706 Phone: 605-385-6700 | |
Joshua R Duncan, MD, MPH Pediatrics Medicare: Medicare Enrolled Practice Location: 2900 Doolittle Dr, Ellsworth Afb, SD 57706 Phone: 605-385-3466 |