Poplar Bluff Hma Physician Management, Llc | |
3098 Oak Grove Rd Poplar Bluff MO 63901-8938 | |
(573) 776-2835 | |
(573) 776-2763 |
Full Name | Poplar Bluff Hma Physician Management, Llc |
---|---|
Speciality | Family Medicine |
Location | 3098 Oak Grove Rd, Poplar Bluff, Missouri |
Authorized Official Name and Position | James P Wright (VP PHYSICIAN BUSINESS SERVICES) |
Authorized Official Contact | 6157781502 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Poplar Bluff Hma Physician Management, Llc Po Box 689022 Franklin TN 37068-9022 Ph: (615) 778-8027 | Poplar Bluff Hma Physician Management, Llc 3098 Oak Grove Rd Poplar Bluff MO 63901-8938 Ph: (573) 776-2835 |
NPI Number | 1598710147 |
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Provider Enumeration Date | 05/23/2006 |
Last Update Date | 11/21/2019 |
Medicare PECOS PAC ID | 5092769703 |
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Medicare Enrollment ID | O20050307000013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598710147 | NPI | - | NPPES |
505101907 | Medicaid | MO |
Provider Name | Muhammad A Salamat |
---|---|
Provider Type | Practitioner - Hematology/oncology |
Provider Identifiers | NPI Number: 1467427740 PECOS PAC ID: 1254231905 Enrollment ID: I20040109001060 |
Provider Name | Talia E Haiderzad |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1669572871 PECOS PAC ID: 4688563281 Enrollment ID: I20040312000048 |
Provider Name | Hanumanth K Reddy |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1053350256 PECOS PAC ID: 9133103260 Enrollment ID: I20040616000742 |
Provider Name | Geetha R. Komatireddy |
---|---|
Provider Type | Practitioner - Rheumatology |
Provider Identifiers | NPI Number: 1861421687 PECOS PAC ID: 7618953340 Enrollment ID: I20040624001515 |
Provider Name | James Z Chen |
---|---|
Provider Type | Practitioner - Radiation Oncology |
Provider Identifiers | NPI Number: 1124056312 PECOS PAC ID: 7810965621 Enrollment ID: I20050117000029 |
Provider Name | Ly T Phan |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1356430870 PECOS PAC ID: 0547288565 Enrollment ID: I20051109000014 |
Provider Name | Marcia Moore |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1760554521 PECOS PAC ID: 2062409238 Enrollment ID: I20061221000190 |
Provider Name | Sanjeev Kamat |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1649375288 PECOS PAC ID: 4385746767 Enrollment ID: I20070305000203 |
Provider Name | Kean D Griffith |
---|---|
Provider Type | Practitioner - Surgical Oncology |
Provider Identifiers | NPI Number: 1821077660 PECOS PAC ID: 5597721316 Enrollment ID: I20070823000616 |
Provider Name | Ajit S Deol |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1508898099 PECOS PAC ID: 3173503737 Enrollment ID: I20080403000197 |
Provider Name | Joey Lawrence Christmas |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1770700619 PECOS PAC ID: 7618043605 Enrollment ID: I20080827000162 |
Provider Name | Syed M S Sayeed |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1619190162 PECOS PAC ID: 0840358289 Enrollment ID: I20081029000130 |
Provider Name | Juan Carlos Salazar |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1922041995 PECOS PAC ID: 5395800932 Enrollment ID: I20090216000454 |
Provider Name | Emelinda V Tolod |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1447498878 PECOS PAC ID: 4981759073 Enrollment ID: I20090825000413 |
Provider Name | Emily Militzer |
---|---|
Provider Type | Practitioner - Radiation Oncology |
Provider Identifiers | NPI Number: 1962431007 PECOS PAC ID: 8628006723 Enrollment ID: I20090910000019 |
Provider Name | Warren M Breite |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1457355372 PECOS PAC ID: 4385790633 Enrollment ID: I20090929000056 |
Provider Name | William M Redden |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1518159714 PECOS PAC ID: 8921145236 Enrollment ID: I20091019000501 |
Provider Name | Jahan Qamar Zeb |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1699710996 PECOS PAC ID: 8022018027 Enrollment ID: I20091112000313 |
Provider Name | Beverly D Smith |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1992833875 PECOS PAC ID: 4981749306 Enrollment ID: I20100309000637 |
Provider Name | Bijan Bastaninejad |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1972589968 PECOS PAC ID: 2961423264 Enrollment ID: I20100519000419 |
Provider Name | Shabbir H Safdar |
---|---|
Provider Type | Practitioner - Hematology/oncology |
Provider Identifiers | NPI Number: 1952380107 PECOS PAC ID: 3678509197 Enrollment ID: I20100617000428 |
Provider Name | Michael J Lim |
---|---|
Provider Type | Practitioner - Interventional Cardiology |
Provider Identifiers | NPI Number: 1235151861 PECOS PAC ID: 9638078272 Enrollment ID: I20100713000422 |
Provider Name | Kareem Husain |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1912025974 PECOS PAC ID: 5496889180 Enrollment ID: I20100817000776 |
Provider Name | Muhammad Javed |
---|---|
Provider Type | Practitioner - Critical Care (intensivists) |
Provider Identifiers | NPI Number: 1275741340 PECOS PAC ID: 6305962309 Enrollment ID: I20100928000352 |
Provider Name | Amy M Pennington |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811293756 PECOS PAC ID: 9830375195 Enrollment ID: I20110520000532 |
Provider Name | Leonidas Theodoro |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1366566408 PECOS PAC ID: 7719941012 Enrollment ID: I20110815000729 |
Provider Name | Theresa E Robertson |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1215019518 PECOS PAC ID: 4082883681 Enrollment ID: I20110817000300 |
Provider Name | Marco V Baquero |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1730298902 PECOS PAC ID: 4183512007 Enrollment ID: I20120725000643 |
Provider Name | David N Brotman |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1033112461 PECOS PAC ID: 1658460605 Enrollment ID: I20121213000086 |
Provider Name | Stanley P Jones |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1487859609 PECOS PAC ID: 3476700931 Enrollment ID: I20130424000859 |
Provider Name | Gary Luther Ward |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1528336294 PECOS PAC ID: 6709013683 Enrollment ID: I20131223000190 |
Provider Name | Robin G Smith |
---|---|
Provider Type | Practitioner - Radiation Oncology |
Provider Identifiers | NPI Number: 1427118686 PECOS PAC ID: 7416906326 Enrollment ID: I20140314000302 |
Provider Name | Sharon D White |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215293378 PECOS PAC ID: 2860657962 Enrollment ID: I20140417001386 |
Provider Name | Kimberly Dawn Te |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497036297 PECOS PAC ID: 9931323235 Enrollment ID: I20140606000342 |
Provider Name | Joseph Michael Arcidi |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1528024544 PECOS PAC ID: 4486619616 Enrollment ID: I20140625001412 |
Provider Name | Carl R Jenson |
---|---|
Provider Type | Practitioner - Radiation Oncology |
Provider Identifiers | NPI Number: 1659317097 PECOS PAC ID: 1355337437 Enrollment ID: I20140630001991 |
Provider Name | Alexandros Georgolios |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1053571794 PECOS PAC ID: 0547409906 Enrollment ID: I20140703001378 |
Provider Name | Muhammad Imran |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1881987071 PECOS PAC ID: 6507085875 Enrollment ID: I20140918001227 |
Provider Name | Bola Gabriel Aladegbami |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1831452952 PECOS PAC ID: 9830414523 Enrollment ID: I20150223000800 |
Provider Name | Victor Lawrinenko |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1831134436 PECOS PAC ID: 0143293100 Enrollment ID: I20150504001844 |
Provider Name | Jehad Haggiagi |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1437420072 PECOS PAC ID: 1658502091 Enrollment ID: I20150513001324 |
Provider Name | Lili Kelly |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1548488570 PECOS PAC ID: 1052419108 Enrollment ID: I20150630001159 |
Provider Name | David W Wood |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760742084 PECOS PAC ID: 9931414901 Enrollment ID: I20150819009284 |
Provider Name | Robin Michele Johnson |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1821060617 PECOS PAC ID: 9537145768 Enrollment ID: I20150923000235 |
Provider Name | Phyllis Eason |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1174596746 PECOS PAC ID: 1355307075 Enrollment ID: I20160210001933 |
Provider Name | Richard Randall Jacobs |
---|---|
Provider Type | Practitioner - Radiation Oncology |
Provider Identifiers | NPI Number: 1447457171 PECOS PAC ID: 6305738550 Enrollment ID: I20160322002429 |
Provider Name | Dawn G Baker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568831048 PECOS PAC ID: 9133419625 Enrollment ID: I20160718001825 |
Provider Name | Chelsea R Fisher |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1972820512 PECOS PAC ID: 4284935016 Enrollment ID: I20160811001513 |
Provider Name | Joshua Lynn Wilson |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1609130061 PECOS PAC ID: 7315176039 Enrollment ID: I20161017000779 |
Provider Name | Mohanad Alfaqih |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1598085235 PECOS PAC ID: 3072746205 Enrollment ID: I20161019000625 |
Provider Name | Jamie Murray |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710420088 PECOS PAC ID: 5496037004 Enrollment ID: I20170116000204 |
Provider Name | Theresa L Pennington |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720445463 PECOS PAC ID: 4183620909 Enrollment ID: I20170126000064 |
Provider Name | Leona M Bergen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831636281 PECOS PAC ID: 4789969965 Enrollment ID: I20170330002241 |
Provider Name | Michelle L Heath |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063944932 PECOS PAC ID: 5496028482 Enrollment ID: I20170913004017 |
Provider Name | Harikrishnan Damodaran-nair |
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Provider Type | Practitioner - Interventional Cardiology |
Provider Identifiers | NPI Number: 1871608125 PECOS PAC ID: 3870675945 Enrollment ID: I20170919003050 |
Provider Name | Bradley K Woods |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1477637148 PECOS PAC ID: 6002988755 Enrollment ID: I20171016001700 |
Provider Name | Ali S Anwar |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1710328703 PECOS PAC ID: 9830328020 Enrollment ID: I20180102001271 |
Provider Name | Siamak Karimian |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1225091812 PECOS PAC ID: 7719933258 Enrollment ID: I20180104001621 |
Provider Name | Ashley Nicole Newman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386834414 PECOS PAC ID: 3072872100 Enrollment ID: I20180118001861 |
Provider Name | Hasan Shanawani |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1285643163 PECOS PAC ID: 3072580158 Enrollment ID: I20180411000920 |
Provider Name | Jason M Loden |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1710327879 PECOS PAC ID: 3779858162 Enrollment ID: I20180709003412 |
Provider Name | Roland Fokwen Njoh |
---|---|
Provider Type | Practitioner - Interventional Cardiology |
Provider Identifiers | NPI Number: 1932429719 PECOS PAC ID: 5799926697 Enrollment ID: I20180821003752 |
Provider Name | Carl Deselm |
---|---|
Provider Type | Practitioner - Radiation Oncology |
Provider Identifiers | NPI Number: 1366705840 PECOS PAC ID: 5890048656 Enrollment ID: I20181024000526 |
Provider Name | William Jennison Bulkley |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1386638286 PECOS PAC ID: 7113074980 Enrollment ID: I20181115000263 |
Provider Name | Carol Lee Pratt |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568946515 PECOS PAC ID: 3274887518 Enrollment ID: I20181126001926 |
Provider Name | Robert B Marcus |
---|---|
Provider Type | Practitioner - Radiation Oncology |
Provider Identifiers | NPI Number: 1023024189 PECOS PAC ID: 8426030685 Enrollment ID: I20190207000391 |
Provider Name | Michael J Del Rio |
---|---|
Provider Type | Practitioner - Thoracic Surgery |
Provider Identifiers | NPI Number: 1073557757 PECOS PAC ID: 5496743130 Enrollment ID: I20190611001227 |
Provider Name | Dustin Woyski |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1255777660 PECOS PAC ID: 1951532266 Enrollment ID: I20190710002593 |
Provider Name | Sina Khoshbin |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1972890564 PECOS PAC ID: 3072817295 Enrollment ID: I20190904000246 |
Provider Name | Zachary Clark Willis |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1265847016 PECOS PAC ID: 1658677687 Enrollment ID: I20190924003590 |
Provider Name | Kashif Hameed |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1235490186 PECOS PAC ID: 0446556591 Enrollment ID: I20190930002859 |
Provider Name | Ibnalwalid A Saad |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1154609626 PECOS PAC ID: 6103157904 Enrollment ID: I20191009000970 |
Provider Name | Barbara Fay Willis |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1245395029 PECOS PAC ID: 9537153432 Enrollment ID: I20191017002378 |
Provider Name | Ivan A. Villalta-wehmeyer |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1932278181 PECOS PAC ID: 9739345539 Enrollment ID: I20191118000360 |
Provider Name | Hector Dox |
---|---|
Provider Type | Practitioner - Thoracic Surgery |
Provider Identifiers | NPI Number: 1154324895 PECOS PAC ID: 4688631138 Enrollment ID: I20200818004001 |
Provider Name | Daniel Lapp |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1568844421 PECOS PAC ID: 9234449075 Enrollment ID: I20200827000538 |
Provider Name | Amit Sharma |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1255738597 PECOS PAC ID: 3678869831 Enrollment ID: I20200827003529 |
Provider Name | Edward Reese |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1013279918 PECOS PAC ID: 5395969323 Enrollment ID: I20210518000780 |
Provider Name | Jacob E Locke |
---|---|
Provider Type | Practitioner - Radiation Oncology |
Provider Identifiers | NPI Number: 1750303160 PECOS PAC ID: 5597723734 Enrollment ID: I20210526000819 |
Provider Name | Derrick Clunis |
---|---|
Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1407832579 PECOS PAC ID: 8527058015 Enrollment ID: I20210712003291 |
Provider Name | Holly Maria Adams |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841899614 PECOS PAC ID: 4385046077 Enrollment ID: I20210719001199 |
Provider Name | Stacy Lee Edgar |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083388359 PECOS PAC ID: 8729483235 Enrollment ID: I20210823000106 |
Provider Name | Megan K Thompson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922677822 PECOS PAC ID: 5496011439 Enrollment ID: I20210824001541 |
Provider Name | Jonathan Workman |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1952699894 PECOS PAC ID: 8820397714 Enrollment ID: I20211207001324 |
Provider Name | Juan Carlos Ruben Ruiz Diaz |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1790192672 PECOS PAC ID: 9830583350 Enrollment ID: I20220228000789 |
Provider Name | Riley Nicole Mckuin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831821420 PECOS PAC ID: 9739564469 Enrollment ID: I20220916001630 |
Provider Name | John Yujun Sheng |
---|---|
Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1396277901 PECOS PAC ID: 9335524206 Enrollment ID: I20220922000860 |
Provider Name | Maxine Theriot |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194874628 PECOS PAC ID: 0648296525 Enrollment ID: I20230322000964 |
Provider Name | Stanley Hahn |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1619977758 PECOS PAC ID: 0648210898 Enrollment ID: I20230614003397 |
Provider Name | Haven Price |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1235799081 PECOS PAC ID: 3870829369 Enrollment ID: I20230818000439 |
Provider Name | Raisa Pinto |
---|---|
Provider Type | Practitioner - Hematology/oncology |
Provider Identifiers | NPI Number: 1760757892 PECOS PAC ID: 3779994728 Enrollment ID: I20240226000521 |
Tinsley Home Medical Services, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2725 N Westwood Blvd, Poplar Bluff, MO 63901 Phone: 573-686-5510 | |
Southern Missouri Sleep Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 922 N Westwood Blvd, Poplar Bluff, MO 63901 Phone: 573-727-9661 Fax: 573-727-9665 | |
Southeasthealth Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2002 Kanell Blvd, Poplar Bluff, MO 63901 Phone: 573-778-0020 Fax: 573-776-7548 | |
Mid-south Health Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 Warrior Ln, Poplar Bluff, MO 63901 Phone: 573-785-0851 | |
Missouri Highlands Health Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2210 Barron Rd Ste 120, Poplar Bluff, MO 63901 Phone: 573-785-6536 Fax: 573-785-0345 | |
Kneibert Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 686 Lester St, Poplar Bluff, MO 63901 Phone: 573-686-2411 Fax: 573-686-8452 | |
Advanced Family Healthcare Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2002 Kanell Blvd, Suite 101, Poplar Bluff, MO 63901 Phone: 573-778-9292 Fax: 573-778-0801 |