| Oms | |
|
1103 E Montclair St Suite 100 Springfield MO 65807-5076 | |
| (417) 887-8800 | |
| (417) 887-6265 |
| Full Name | Oms |
|---|---|
| Speciality | Dentist |
| Location | 1103 E Montclair St, Springfield, Missouri |
| Authorized Official Name and Position | Susan Rust (ADMINISTRATOR) |
| Authorized Official Contact | 4178878800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oms 1103 E Montclair St Suite 100 Springfield MO 65807-5076 Ph: (417) 887-8800 | Oms 1103 E Montclair St Suite 100 Springfield MO 65807-5076 Ph: (417) 887-8800 |
| NPI Number | 1801091657 |
|---|---|
| Provider Enumeration Date | 06/20/2007 |
| Last Update Date | 01/18/2024 |
| Certification Date | 01/18/2024 |
| Medicare PECOS PAC ID | 6103886981 |
|---|---|
| Medicare Enrollment ID | O20041015000432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801091657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Missouri) | Primary |
| Provider Name | James D Gipson |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1417942426 PECOS PAC ID: 7113972787 Enrollment ID: I20051129000040 |
| Provider Name | Thomas a Collins |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1831184423 PECOS PAC ID: 1759336324 Enrollment ID: I20051129000184 |
| Provider Name | Steven P Quinn |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1144215740 PECOS PAC ID: 2668427238 Enrollment ID: I20051129000329 |
| Provider Name | George E Arquitt |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1720073703 PECOS PAC ID: 9032139605 Enrollment ID: I20051129000368 |
| Provider Name | Christopher M Meyer |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1861437055 PECOS PAC ID: 6901997220 Enrollment ID: I20070801000089 |
| Provider Name | James Todd Shaner |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1952617698 PECOS PAC ID: 5890927537 Enrollment ID: I20210406001205 |
| Provider Name | James M Koon |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1992258768 PECOS PAC ID: 9638697634 Enrollment ID: I20250514000188 |
| Provider Name | Scott R Sullivan |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1972134567 PECOS PAC ID: 9133603343 Enrollment ID: I20260325000985 |
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