Maxine A Theriot, MD is a medicare enrolled "Preventive Medicine - Undersea And Hyperbaric Medicine" physician in Poplar Bluff, Missouri. Her current practice location is
3098 Oak Grove Rd, Poplar Bluff, Missouri. You can reach out to her office (for appointments etc.) via phone at
(573) 686-8199.
Maxine A Theriot is licensed to practice in Missouri (license number 2022047286) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1194874628.
Physician's Profile
Full Name | Maxine A Theriot |
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Gender | Female |
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Speciality | |
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Experience | Years |
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Location | 3098 Oak Grove Rd, Poplar Bluff, Missouri |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Maxine A Theriot attended and graduated from in
NPI Data:
- NPI Number: 1194874628
- Provider Enumeration Date: 01/10/2007
- Last Update Date: 07/13/2023
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Maxine A Theriot such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1194874628 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | J9578 (Texas) | Secondary |
2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | J9578 (Texas) | Secondary |
2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | 2022047286 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Maxine A Theriot is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Maxine A Theriot, MD 709 W Rusk St Ste B, Rockwall, TX 75087-3600 Ph: (972) 786-0140 | Maxine A Theriot, MD 3098 Oak Grove Rd, Poplar Bluff, MO 63901-8938 Ph: (573) 686-8199 |
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