John D Despain, MD | |
5721 Osage Beach Pkwy Ste 100, Osage Beach, MO 65065-3030 | |
(573) 302-4696 | |
(573) 302-4698 |
Full Name | John D Despain |
---|---|
Gender | Male |
Speciality | Dermatology |
Experience | 40 Years |
Location | 5721 Osage Beach Pkwy Ste 100, Osage Beach, Missouri |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1932196433 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207ND0900X | Dermatology - Dermatopathology | R8E64 (Missouri) | Secondary |
207N00000X | Dermatology | R8E64 (Missouri) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Lake Regional Health System | Osage beach, MO | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Forefront Dermatology | 3779471701 | 483 |
Entity Name | Jefferson City Medical Group Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336189398 PECOS PAC ID: 1850371089 Enrollment ID: O20040908000924 |
Entity Name | Boyce & Bynum Pathology Professional Services Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1689634818 PECOS PAC ID: 0042384976 Enrollment ID: O20080811000335 |
Entity Name | Forefront Dermatology Sc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891179040 PECOS PAC ID: 3779471701 Enrollment ID: O20150922001275 |
Mailing Address | Practice Location Address |
---|---|
John D Despain, MD 801 York St, Manitowoc, WI 54220-4630 Ph: (920) 663-9008 | John D Despain, MD 5721 Osage Beach Pkwy Ste 100, Osage Beach, MO 65065-3030 Ph: (573) 302-4696 |
Karen L Eshraghi, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 5721 Osage Beach Pkwy Ste 100, Osage Beach, MO 65065 Phone: 573-302-4696 Fax: 573-302-4698 |