Inn T Park (NPI# 1588713853, PAC ID# 4082873492) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL PRACTICE.
| Nation Provider ID (NPI) | 1588713853 |
| PAC ID by PECOS | 4082873492 |
| Professional Enrollment ID | I20120305000203 |
| Full Name | Inn T Park |
| Organization Legal Name | STATE OF MISSOURI |
| Address |
2041 E Hunter St Ab Nevada MO 64772-8478 |
| Phone Number | 4176677833 |
| Gender | M |
| Graduation Year | 1963 |
| Primary Specialty | GENERAL PRACTICE |
| Secondary Specialties | PATHOLOGY |
| Group Practice PAC ID | 1456254226 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260020 | MERCY HOSPITAL ST LOUIS |
| Address | Phone | Organization |
|---|---|---|
| 2041 E Hunter St Ab, Nevada, MO 64772-8478 | 4176677833 | STATE OF MISSOURI |
| Organization Legal Name | STATE OF MISSOURI |
| Physicians | 34 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Katelynn R Crawford | Nurse Practitioner | State of Missouri | 3505 Frederick Ave, Saint Joseph, MO 64506-2914 |
| Erich Haezebrouck | Psychologist, Clinical | State of Missouri | 5351 Delmar Blvd, Saint Louis, MO 63112-3146 |
| Ralph Leigh | Emergency Medicine | State of Missouri | 1010 W Columbia St, Farmington, MO 63640-2902 |
| Mark A Felchlia | Psychologist, Clinical | State of Missouri | 5300 Arsenal St, Saint Louis, MO 63139-1463 |
| Preston B Howerton | Internal Medicine | State of Missouri | 1547 Commerce Dr, Marshall, MO 65340-3907 |
| Sridevi Gavirneni | Psychiatry | State of Missouri | 10695 Bellefontaine Rd, Saint Louis, MO 63137-2315 |
| Lewis Peck Shilane | Family Practice | State of Missouri | 2041 E Hunter St Ab, Nevada, MO 64772-8478 |
| Amalakumar Dominic Augustine | Internal Medicine | State of Missouri | 22 Marr Ln, Saint Charles, MO 63303-9000 |
| Brandy Baczwaski | Psychologist, Clinical | State of Missouri | 600 E 5th St, Fulton State Hospital, Fulton, MO 65251-1793 |
| William R Enochs | Psychiatry | State of Missouri | 3505 Frederick Ave, Saint Joseph, MO 64506-2914 |
| Street Address |
2041 E HUNTER ST AB |
| City | NEVADA |
| State | MO |
| Zip | 64772-8478 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lewis Peck Shilane | Family Practice | State of Missouri | 2041 E Hunter St Ab, Nevada, MO 64772-8478 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wesley M Ledom | Psychologist, Clinical | 700 E Highland Ave, Nevada, MO 64772-1025 | |
| Gary A Kurtz | Chiropractic | 1804 N Ash St, Nevada, MO 64772-1110 | |
| David L Neidel | Clinical Social Worker | 100 S Prewitt, Nevada, MO 64772-1760 | |
| Robert F Ingegneri | Psychologist, Clinical | 300 W Cherry St, Nevada, MO 64772-2202 | |
| Mark Harvey Comensky | Psychologist, Clinical | 300 W Cherry St, Nevada, MO 64772-2202 | |
| Jeremy Michael Fast | Optometry | Eyecare Professionals Inc | 111 N Main St, Nevada, MO 64772-2330 |
| Delton L Fast | Optometry | Eyecare Professionals Inc | 111 N Main St, Nevada, MO 64772-2330 |
| Nathan S Box | Otolaryngology | Freeman-oak Hill Health System | 216 N Main, Freeman Heart Institute, Nevada, MO 64772-2332 |
| Russell R Kemm | Family Medicine | 216 N Main, Nevada, MO 64772-2332 | |
| Linda Davidson | Psychologist, Clinical | 212 N Main St, Nevada, MO 64772-2332 | |
| Find all physicians in zip 64772 | |||
| City | NEVADA |
| Zip Code | 64772 |
| Specialty | GENERAL PRACTICE |
| City + Specialty | NEVADA + GENERAL PRACTICE |
Please comment or provide details below to improve the information on Inn T Park.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.