Brent R Fairbanks, AA | |
1235 E Cherokee, Springfield, MO 65804-2203 | |
(417) 820-2829 | |
(417) 820-8852 |
Full Name | Brent R Fairbanks |
---|---|
Gender | Male |
Speciality | Anesthesiology Assistant |
Experience | 13 Years |
Location | 1235 E Cherokee, Springfield, 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 |
---|---|---|---|
1538418793 | NPI | - | NPPES |
1538418793 | Medicaid | MO | |
P01129106 | Other | MO | RR MCR |
431560263 | Other | MO | TRICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367H00000X | Anesthesiologist Assistant | 2012028957 (Missouri) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Phoebe Putney Memorial Hospital | Albany, GA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Phoebe Physician Group Inc | 8426112350 | 351 |
Entity Name | Phoebe Physician Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487899464 PECOS PAC ID: 8426112350 Enrollment ID: O20090121000583 |
Mailing Address | Practice Location Address |
---|---|
Brent R Fairbanks, AA P.o. Box 2580, Springfield, MO 65801-2580 Ph: (417) 829-4620 | Brent R Fairbanks, AA 1235 E Cherokee, Springfield, MO 65804-2203 Ph: (417) 820-2829 |
Charis Denovi, Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 3801 S National Ave, Springfield, MO 65807 Phone: 417-269-6000 | |
Asher Herbet, Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 3801 S National Ave, Springfield, MO 65807 Phone: 417-269-6000 | |
Kayla Conner Gibson, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 1000 E Primrose St Ste 520, Springfield, MO 65807 Phone: 417-269-4550 | |
Taylor G Harris, AA-C Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 1000 E Primrose St, Springfield, MO 65807 Phone: 417-269-4550 | |
Corrine Calzone, C-AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 1000 E Primrose St Ste 520, Springfield, MO 65807 Phone: 417-269-4550 | |
Brittany Anderson, Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 3801 S National Ave, Springfield, MO 65807 Phone: 417-269-6000 | |
Jonathan D Brady, AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2829 Fax: 417-820-8852 |