Gordon R Wouters (NPI# 1851402010, PAC ID# 9537150289) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1851402010 |
| PAC ID by PECOS | 9537150289 |
| Professional Enrollment ID | I20040520001224 |
| Full Name | Gordon R Wouters |
| Address |
111 N Main St Urbana MO 65767-9152 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES |
| Graduation Year | 1995 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260195 | CITIZENS MEMORIAL HOSPITAL |
| 260040 | COX MEDICAL CENTERS |
| Address | Phone | Organization |
|---|---|---|
| 111 N Main St, Urbana, MO 65767-9152 |
| Street Address |
111 N MAIN ST |
| City | URBANA |
| State | MO |
| Zip | 65767-9152 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrew E Paull | Chiropractic | 111 N Main St, Suite 100, Janesville, WI 53545-3072 | |
| Deborah Roberts Spicer | Clinical Social Worker | 111 N Main St, Cynthiana, KY 41031-1206 | |
| 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 |
| City | URBANA |
| Zip Code | 65767 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | URBANA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Gordon R Wouters.
| 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.