| Drx - East Missouri Providers, P.c. | |
|
465 S Mount Auburn Rd Ste 103 Cape Girardeau MO 63703-4900 | |
| (573) 335-2900 | |
| (573) 335-2905 |
| Full Name | Drx - East Missouri Providers, P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 465 S Mount Auburn Rd Ste 103, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Mark A Sindecuse (OWNER) |
| Authorized Official Contact | 5733352900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Drx - East Missouri Providers, P.c. 1610 N Kingshighway St Third Floor, Suite 301 Cape Girardeau MO 63701-2196 Ph: (573) 275-8067 | Drx - East Missouri Providers, P.c. 465 S Mount Auburn Rd Ste 103 Cape Girardeau MO 63703-4900 Ph: (573) 335-2900 |
| NPI Number | 1477867844 |
|---|---|
| Provider Enumeration Date | 07/28/2010 |
| Last Update Date | 06/23/2021 |
| Medicare PECOS PAC ID | 8921294257 |
|---|---|
| Medicare Enrollment ID | O20101129000114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477867844 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (Missouri) | Primary |
| Provider Name | Phu Thanh Tran |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427095132 PECOS PAC ID: 3072562362 Enrollment ID: I20050113000337 |
| Provider Name | Carmelita M Hudson Kane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447297155 PECOS PAC ID: 9830101922 Enrollment ID: I20060607000143 |
| Provider Name | Sierra Masters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316639263 PECOS PAC ID: 0345607255 Enrollment ID: I20230608001889 |
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