|
| |
|
408 N. 4th St Suite B Odessa MO 64076-1646 | |
| (816) 230-8777 | |
| (816) 230-8855 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 408 N. 4th St, Odessa, Missouri |
| Authorized Official Name and Position | Bradley L Zink (PHYSICIAN OWNER) |
| Authorized Official Contact | 8162308777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
408 N. 4th St Suite B Odessa MO 64076-1646 Ph: (816) 230-8777 | 408 N. 4th St Suite B Odessa MO 64076-1646 Ph: (816) 230-8777 |
| NPI Number | 1023224904 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 08/09/2023 |
| Medicare PECOS PAC ID | 9335161819 |
|---|---|
| Medicare Enrollment ID | O20051227000530 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023224904 | NPI | - | NPPES |
| 12844049 | Other | MO | BCBSKC INDIVIDUAL PROV |
| 31334013 | Other | MO | BCBSKC GRP NUMBER |
| M140000 | Other | MO | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DOR9F95 (Missouri) | Primary |
| Provider Name | Bradley L Zink |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316901010 PECOS PAC ID: 4789606260 Enrollment ID: I20091123000448 |
| Provider Name | Jessica Lynn Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891340584 PECOS PAC ID: 4587026349 Enrollment ID: I20230811000406 |
Compass Health, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1278 W Us Highway 40, Odessa, MO 64076 Phone: 816-633-5921 | |
Odessa Eye Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 N 2nd St Ste C, Odessa, MO 64076 Phone: 816-230-5321 Fax: 816-565-2288 | |