Edward Allan Grimball, MD | |
402 Bogle St, Ste 3, Somerset, KY 42503-2870 | |
(606) 451-9953 | |
(606) 451-1533 |
Full Name | Edward Allan Grimball |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 402 Bogle St, Somerset, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144211541 | NPI | - | NPPES |
000000075035 | Other | KY | ANTHEM |
5169150 | Other | KY | CCN/AETNA |
37J8 | Other | KY | ANTHEM |
1101698818 | Other | KY | MEDICARE RAILROAD |
1181211 | Other | KY | CHA |
611350780 | Other | KY | FEDERAL TAX ID |
04-906 | Other | KY | UNITED HEALTHCARE |
64297021 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 29702 (Kentucky) | Primary |
207P00000X | Emergency Medicine | 29702 (Kentucky) | Secondary |
Entity Name | Southern Medical Partners, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1538109962 PECOS PAC ID: 8123923679 Enrollment ID: O20031206000036 |
Entity Name | Southeastern Emergency Physicians Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050302000285 |
Mailing Address | Practice Location Address |
---|---|
Edward Allan Grimball, MD 402 Bogle St, Ste 3, Somerset, KY 42503-2870 Ph: (606) 451-9953 | Edward Allan Grimball, MD 402 Bogle St, Ste 3, Somerset, KY 42503-2870 Ph: (606) 451-9953 |
Dr. Jordan Laferty, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 303 Langdon St, Somerset, KY 42503 Phone: 606-451-5093 Fax: 606-451-5087 | |
Joseph G Weigel, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 350 Hospital Way, Suite 100, Somerset, KY 42503 Phone: 606-451-2629 Fax: 606-451-2641 | |
Dr. Harold Helton Jr., M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 104 Hardin Ln Ste A, Somerset, KY 42503 Phone: 606-678-2063 Fax: 606-678-2218 | |
Todd L Horn, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 56 Tower Cir, Somerset, KY 42503 Phone: 606-677-2913 Fax: 606-677-6983 | |
Abdul Rehman, Internal Medicine Medicare: Medicare Enrolled Practice Location: 305 Langdon St, Somerset, KY 42503 Phone: 606-678-3110 | |
Dannette Cook, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 305 Langdon St, Suite H, Somerset, KY 42503 Phone: 606-451-2994 |