417 Sports Medicine And Orthopedics Llc | |
3328 S National Ave Springfield MO 65807-7305 | |
(417) 771-3147 | |
Not Available |
Full Name | 417 Sports Medicine And Orthopedics Llc |
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Speciality | Family Medicine |
Location | 3328 S National Ave, Springfield, Missouri |
Authorized Official Name and Position | Eric Gifford (PHYSICIAN) |
Authorized Official Contact | 8178255096 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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417 Sports Medicine And Orthopedics Llc 2100 E Norshire St Springfield MO 65804-7829 Ph: (817) 825-5096 | 417 Sports Medicine And Orthopedics Llc 3328 S National Ave Springfield MO 65807-7305 Ph: (417) 771-3147 |
NPI Number | 1871105312 |
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Provider Enumeration Date | 08/17/2020 |
Last Update Date | 05/16/2024 |
Medicare PECOS PAC ID | 8628495678 |
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Medicare Enrollment ID | O20200904001390 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871105312 | NPI | - | NPPES |
7860260001 | Other | NATIONAL SUPPLIER CLEARING HOUSE |
Taxonomy | Type | License (State) | Status |
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207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
Provider Name | Eric M Gifford |
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Provider Type | Practitioner - Sports Medicine |
Provider Identifiers | NPI Number: 1144532490 PECOS PAC ID: 5496991077 Enrollment ID: I20140604002364 |
Provider Name | Nathan Isaac Graff |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609195569 PECOS PAC ID: 8426441890 Enrollment ID: I20220207001896 |
James M. Carmichael, Dc Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3108 S Fremont Ave, Springfield, MO 65804 Phone: 417-886-4910 Fax: 417-886-4910 | |
Mercy Clinic Hospitalists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2600 Fax: 417-820-2100 | |