Dr Linda A Tackes, MD | |
5114 Mid America Plz, Ste 2c, Saint Louis, MO 63129-0003 | |
(314) 859-4000 | |
(314) 273-4110 |
Full Name | Dr Linda A Tackes |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 5114 Mid America Plz, 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 |
---|---|---|---|
1003848425 | NPI | - | NPPES |
208556605 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 103626 (Missouri) | Primary |
Entity Name | Premier Pediatrics Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083195762 PECOS PAC ID: 3678817921 Enrollment ID: O20181128000250 |
Mailing Address | Practice Location Address |
---|---|
Dr Linda A Tackes, MD Po Box 505488, Saint Louis, MO 63150-5488 Ph: (314) 859-4000 | Dr Linda A Tackes, MD 5114 Mid America Plz, Ste 2c, Saint Louis, MO 63129-0003 Ph: (314) 859-4000 |
Dr. Rachel Elizabeth Granberg, MD, MPH Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Pl Msc 8116-0043-09, Saint Louis, MO 63110 Phone: 314-454-6018 Fax: 844-621-4392 | |
Timothy J Kutz, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1465 S Grand Blvd, Saint Louis, MO 63104 Phone: 314-268-6406 Fax: 314-268-2712 | |
Dr. William L Rives, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Pl, Div Ped Hospitalist Med, Saint Louis, MO 63110 Phone: 314-454-2076 Fax: 314-747-8953 | |
Dr. Peter M Kilbridge, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1 Childrens Pl, Suite C, Saint Louis, MO 63110 Phone: 314-454-2479 Fax: 314-454-2524 | |
Sarah B. Aschkenasi, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 660 S Euclid Ave, Saint Louis, MO 63110 Phone: 314-286-1264 Fax: 314-454-8869 | |
Dr. Jeffrey Magee, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Pl, Div Ped Hematology And Onc, Ste 9s, Saint Louis, MO 63110 Phone: 314-454-6018 Fax: 844-621-4392 |