Jacob Graham Lanter, | |
739 N Jefferson St, Mascoutah, IL 62258-1447 | |
(618) 566-8810 | |
Not Available |
Full Name | Jacob Graham Lanter |
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Gender | Male |
Speciality | Family Medicine |
Location | 739 N Jefferson St, Mascoutah, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417419714 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036161533 (Illinois) | Primary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Entity Name | Rural Family Medicine Associates Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366639759 PECOS PAC ID: 2264489038 Enrollment ID: O20050404000800 |
Mailing Address | Practice Location Address |
---|---|
Jacob Graham Lanter, 739 N Jefferson St, Mascoutah, IL 62258-1447 Ph: (618) 566-8810 | Jacob Graham Lanter, 739 N Jefferson St, Mascoutah, IL 62258-1447 Ph: (618) 566-8810 |
Paul J Reger, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 739 N Jefferson St, Suite 200, Mascoutah, IL 62258 Phone: 618-566-8810 Fax: 618-566-7121 | |
Steven D Pritchett, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 739 N Jefferson St, Suite 200, Mascoutah, IL 62258 Phone: 618-566-8810 Fax: 618-566-7121 | |
Judith K Weis, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 739 N Jefferson St, Suite 200, Mascoutah, IL 62258 Phone: 618-566-8810 Fax: 618-566-7121 |