John Paul Koonce, MD | |
3207 W Truman Blvd, Jefferson City, MO 65109-0578 | |
(573) 636-5115 | |
(573) 636-2818 |
Full Name | John Paul Koonce |
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Gender | Male |
Speciality | Urology |
Location | 3207 W Truman Blvd, Jefferson City, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538180393 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | R1D96 (Missouri) | Primary |
Entity Name | Ssm Audrain Health Care Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841334836 PECOS PAC ID: 3678481827 Enrollment ID: O20040129000368 |
Entity Name | Noble Health Audrain Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1447841168 PECOS PAC ID: 0446667299 Enrollment ID: O20210430001237 |
Mailing Address | Practice Location Address |
---|---|
John Paul Koonce, MD 3207 W Truman Blvd, Jefferson City, MO 65109-0578 Ph: (573) 636-5115 | John Paul Koonce, MD 3207 W Truman Blvd, Jefferson City, MO 65109-0578 Ph: (573) 636-5115 |
Eric Ivan Vogt, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 3207 W Truman Blvd, Jefferson City, MO 65109 Phone: 573-636-5115 | |
Douglas Alan West, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 3207 W Truman Blvd, Jefferson City, MO 65109 Phone: 573-636-5115 Fax: 573-636-2818 | |
Dr. Jerry Jeff Trulson, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 3207 W Truman Blvd, Jefferson City, MO 65109 Phone: 573-636-5115 Fax: 573-636-2818 | |
Michael Scott Severance, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 3207 W Truman Blvd, Jefferson City, MO 65109 Phone: 573-636-5115 Fax: 573-636-2818 |