Jacquelyn B Garrett, MD | |
11125 Dunn Rd, Ste 411, Saint Louis, MO 63136-6132 | |
(314) 355-7111 | |
(314) 355-8604 |
Full Name | Jacquelyn B Garrett |
---|---|
Gender | Female |
Speciality | Dermatology |
Location | 11125 Dunn Rd, Saint Louis, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851495907 | NPI | - | NPPES |
203880802 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | R4G86 (Missouri) | Primary |
Entity Name | Deluxe Dermatology Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922605906 PECOS PAC ID: 1850702010 Enrollment ID: O20201119003292 |
Mailing Address | Practice Location Address |
---|---|
Jacquelyn B Garrett, MD 11125 Dunn Rd Ste 411, Saint Louis, MO 63136-6132 Ph: (314) 355-7111 | Jacquelyn B Garrett, MD 11125 Dunn Rd, Ste 411, Saint Louis, MO 63136-6132 Ph: (314) 355-7111 |
Dr. Caroline M Mann, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 969 N Mason Rd, Div Im Dermatology, Ste 220, Saint Louis, MO 63141 Phone: 314-273-3376 Fax: 888-682-0525 | |
Shane A Grace, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 12855 N 40 Dr Ste 180, Saint Louis, MO 63141 Phone: 314-878-5599 Fax: 314-392-4290 | |
Dr. Lee S Portnoff, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3009 N Ballas Rd, Ste 310a, Saint Louis, MO 63131 Phone: 314-993-2909 | |
Aibing Mary Guo, M.D. Dermatology Medicare: May Accept Medicare Assignments Practice Location: 1225 S Grand Blvd Fl 3, Saint Louis, MO 63104 Phone: 314-977-3400 Fax: 314-977-7613 | |
Dr. Amy C Musiek, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4901 Forest Park Ave, Div Im Dermatology, Ste 502, Saint Louis, MO 63108 Phone: 314-273-3376 Fax: 888-665-8309 | |
Dr. Gillian Meade Heinecke, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 1755 S Grand Blvd, Saint Louis, MO 63104 Phone: 314-256-3430 Fax: 314-256-3431 | |
Nicole M Burkemper, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 1225 S Grand Blvd Fl 3, Saint Louis, MO 63104 Phone: 314-977-3400 Fax: 314-977-7613 |