| Coxhealth Diabetes And Endocrinology | |
|
1601 Branson Hills Pkwy Ste 110 Branson MO 65616-9908 | |
| (417) 348-8990 | |
| (417) 348-8090 |
| Full Name | Coxhealth Diabetes And Endocrinology |
|---|---|
| Speciality | Internal Medicine |
| Location | 1601 Branson Hills Pkwy Ste 110, Branson, Missouri |
| Authorized Official Name and Position | William K Mahoney (CEO) |
| Authorized Official Contact | 4173357270 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coxhealth Diabetes And Endocrinology Po Box 505673 Saint Louis MO 63150-5673 Ph: (417) 730-6430 | Coxhealth Diabetes And Endocrinology 1601 Branson Hills Pkwy Ste 110 Branson MO 65616-9908 Ph: (417) 348-8990 |
| NPI Number | 1346352606 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 09/30/2024 |
| Medicare PECOS PAC ID | 5092624320 |
|---|---|
| Medicare Enrollment ID | O20060511000211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346352606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Jonben D Svoboda |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1831198993 PECOS PAC ID: 5092755033 Enrollment ID: I20050509000842 |
| Provider Name | James T Bonucchi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1225054109 PECOS PAC ID: 0749286607 Enrollment ID: I20080801000046 |
| Provider Name | Helen M Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073921334 PECOS PAC ID: 2466672480 Enrollment ID: I20140925000835 |
| Provider Name | Candace C Roland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063820421 PECOS PAC ID: 5395966964 Enrollment ID: I20141023001613 |
| Provider Name | Anju S Prasad |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1992069736 PECOS PAC ID: 1759684160 Enrollment ID: I20180126002458 |
| Provider Name | Haley R Mease |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528637873 PECOS PAC ID: 6709288731 Enrollment ID: I20210713001487 |
| Provider Name | Gwenyth L Nel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659087310 PECOS PAC ID: 8426422999 Enrollment ID: I20230323002263 |
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