James L Livermore, MD | |
1789 Elm St, Suite A, Dubuque, IA 52001-2256 | |
(563) 690-2860 | |
(563) 582-5335 |
Full Name | James L Livermore |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 1789 Elm St, Dubuque, Iowa |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497846679 | NPI | - | NPPES |
200522050 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 38859 (Iowa) | Primary |
Entity Name | Crescent Community Health Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720146319 PECOS PAC ID: 0345343158 Enrollment ID: O20070806000462 |
Mailing Address | Practice Location Address |
---|---|
James L Livermore, MD 1789 Elm St, Suite A, Dubuque, IA 52001-2256 Ph: (563) 690-2860 | James L Livermore, MD 1789 Elm St, Suite A, Dubuque, IA 52001-2256 Ph: (563) 690-2860 |
Mitchell Lee Edwards, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1500 Associates Dr, Dubuque, IA 52002 Phone: 563-584-3000 | |
David E Kragenbrink, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1500 Delhi St, Suite 3500, Dubuque, IA 52001 Phone: 563-557-5911 Fax: 563-557-5910 | |
Ankura Kadakia, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1500 Delhi St Ste 3500, Dubuque, IA 52001 Phone: 563-557-3900 | |
Heather-lynn Menezes, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 Langworthy St, Dubuque, IA 52001 Phone: 563-584-3440 Fax: 563-584-3009 | |
Shiny Susan Kunjummen, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1500 Delhi St Ste 3500, Dubuque, IA 52001 Phone: 563-557-5911 | |
Donald Harvey Reyerson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1500 Associates Dr, Dubuque, IA 52002 Phone: 563-584-4440 Fax: 563-584-4295 | |
Susan Light Roewe, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1690 Elm St Ste 300, Dubuque, IA 52001 Phone: 563-690-2850 Fax: 563-557-8488 |