| Jeremy Polk, AA | |
|
10010 Kennerly Rd, Saint Louis, MO 63128-2106 | |
| (636) 386-3722 | |
| (636) 200-4036 |
| Full Name | Jeremy Polk |
|---|---|
| Gender | Male |
| Speciality | Anesthesiologist Assistant |
| Location | 10010 Kennerly Rd, 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 |
|---|---|---|---|
| 1346699865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367H00000X | Anesthesiologist Assistant | 2016017707 (Missouri) | Primary |
| Entity Name | South County Anesthesia Associates Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821031659 PECOS PAC ID: 4082510383 Enrollment ID: O20031209000161 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremy Polk, AA Po Box 22407, Saint Louis, MO 63126-0407 Ph: (636) 386-7222 | Jeremy Polk, AA 10010 Kennerly Rd, Saint Louis, MO 63128-2106 Ph: (636) 386-3722 |
Jeremy Stephen Colyer, AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 10010 Kennerly Rd, Saint Louis, MO 63128 Phone: 636-386-7222 Fax: 636-200-4036 | |
Mrs. Maria Jones, C-AA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 615 S New Ballas Rd Dept Of, Saint Louis, MO 63141 Phone: 636-386-9224 Fax: 636-200-4243 | |
Alexander Sextro, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 11133 Dunn Rd, Saint Louis, MO 63136 Phone: 314-653-5000 | |
Alexis Haas Stewart, Anesthesiologist Assistant Medicare: May Accept Medicare Assignments Practice Location: 1465 S Grand Blvd, Saint Louis, MO 63104 Phone: 314-977-5700 | |
Mr. Brian J Ho, A.A. Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 615 S New Ballas Rd, Dept. Of Anesthesiology, Saint Louis, MO 63141 Phone: 314-251-4687 Fax: 636-200-4243 | |
Laheart Marie Rodney, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 1465 S Grand Blvd, Saint Louis, MO 63104 Phone: 314-268-7267 | |
Mr. Nick Balarama Rodriguez, AA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 615 S New Ballas Rd Dept Of, Saint Louis, MO 63141 Phone: 636-386-9224 Fax: 636-386-7679 |