| |
960 E Walnut Lawn St Ste 202 Springfield MO 65807-7865 | |
(417) 269-1045 | |
(417) 269-1065 |
Full Name | |
---|---|
Speciality | Internal Medicine |
Location | 960 E Walnut Lawn St Ste 202, Springfield, Missouri |
Authorized Official Name and Position | Jacob Mcway (EXECUTIVE VP & CFO) |
Authorized Official Contact | 4172698811 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 505673 Saint Louis MO 63150-5673 Ph: (417) 730-6430 | 960 E Walnut Lawn St Ste 202 Springfield MO 65807-7865 Ph: (417) 269-1045 |
NPI Number | 1831826197 |
---|---|
Provider Enumeration Date | 08/05/2022 |
Last Update Date | 09/27/2024 |
Medicare PECOS PAC ID | 1254248917 |
---|---|
Medicare Enrollment ID | O20221005002781 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831826197 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Linda R Macgorman |
---|---|
Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1124023726 PECOS PAC ID: 6002818044 Enrollment ID: I20070205000494 |
Provider Name | Brittany J Allen |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1043474778 PECOS PAC ID: 6608992003 Enrollment ID: I20100922001117 |
Provider Name | Ryan G Jones |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1023459971 PECOS PAC ID: 2163650649 Enrollment ID: I20140107001186 |
Provider Name | Vincen Gene Barnes |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1093870875 PECOS PAC ID: 5294814893 Enrollment ID: I20190114002966 |
Provider Name | Muriel Tania Go |
---|---|
Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1205219821 PECOS PAC ID: 1850697905 Enrollment ID: I20230425000934 |
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 | |