| Adon Harris, MD | |
|
2016 S Main St, Maryville, MO 64468-2655 | |
| (660) 562-7999 | |
| (660) 562-7996 |
| Full Name | Adon Harris |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 8 Years |
| Location | 2016 S Main St, Maryville, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417448507 | NPI | - | NPPES |
| 4301115278 | Medicaid | MI | |
| 5315092623 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 2024032663 (Missouri) | Primary |
| 208600000X | Surgery | 4301115278 (Michigan) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mosaic Life Care At St Joseph | Saint joseph, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mosaic Medical Center - Maryville | 3678813896 | 73 |
| Ssm Regional Health Services | 8921917352 | 133 |
| Entity Name | Mosaic Medical Center - Maryville |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184189797 PECOS PAC ID: 3678813896 Enrollment ID: O20190405001537 |
| Mailing Address | Practice Location Address |
|---|---|
| Adon Harris, MD 4500 Cass Ave Apt 913, Detroit, MI 48201-1286 Ph: (316) 209-1654 | Adon Harris, MD 2016 S Main St, Maryville, MO 64468-2655 Ph: (660) 562-7999 |
Dr. James E. Bradley, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 2016 S Main St, Maryville, MO 64468 Phone: 660-562-2525 Fax: 660-562-7993 | |
Shellie Kathleen Faris, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2016 S Main St, Maryville, MO 64468 Phone: 660-562-2525 Fax: 660-562-4303 | |
Anthony Paul Melillo, Surgery Medicare: Accepting Medicare Assignments Practice Location: 2016 S Main St, Maryville, MO 64468 Phone: 660-562-2525 Fax: 660-562-7996 | |
Dr. Manuel W. Runez, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 2016 S Main St, Maryville, MO 64468 Phone: 660-562-2525 Fax: 660-562-7993 | |
Jack L Forest, D.O. Surgery Medicare: Medicare Enrolled Practice Location: 2016 S Main St, Maryville, MO 64468 Phone: 660-562-2600 Fax: 660-562-7911 |