Keith Edward Segall, DO | |
111 Parkway, Vienna, MO 65582-8003 | |
(573) 422-3360 | |
(573) 422-3391 |
Full Name | Keith Edward Segall |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 111 Parkway, Vienna, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639245368 | NPI | - | NPPES |
0120039 | Other | UNITED HEALTHCARE | |
10048 | Other | MO | BLUE CROSS |
1904V1471 | Other | HEALTHCARE USA | |
257668 | Other | MO | HEALTHLINK |
G00218 | Other | MO | MERCY HEALTH PLAN |
13680 | Other | GROUP HEALTH PLAN | |
247757602 | Medicaid | MO | |
V410 | Other | MO | MISSOURI CARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | D0106518 (Missouri) | Primary |
Entity Name | Regional Health Care Clinic Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922057504 PECOS PAC ID: 8224926092 Enrollment ID: O20040304001212 |
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 | Capital Region Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477980837 PECOS PAC ID: 4688573686 Enrollment ID: O20070323000507 |
Entity Name | Regional Health Care Clinic Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053694422 PECOS PAC ID: 8224926092 Enrollment ID: O20111201000035 |
Mailing Address | Practice Location Address |
---|---|
Keith Edward Segall, DO 111 Parkway, Vienna, MO 65582-8003 Ph: (573) 422-3360 | Keith Edward Segall, DO 111 Parkway, Vienna, MO 65582-8003 Ph: (573) 422-3360 |