| Bradley D Wiley, MD | |
|
1001 E Primrose St, Springfield, MO 65807-5155 | |
| (417) 875-3000 | |
| (417) 875-3051 |
| Full Name | Bradley D Wiley |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 33 Years |
| Location | 1001 E Primrose St, Springfield, 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 |
|---|---|---|---|
| 1013950070 | NPI | - | NPPES |
| 208645200 | Medicaid | MO | |
| 105284 | Other | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 111451 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Coxhealth At Home | Springfield, MO | Home health agency |
| Cox Medical Centers | Springfield, MO | Hospital |
| Cox Medical Center Branson | Branson, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lester E Cox Medical Centers | 8628092897 | 242 |
| Entity Name | Lester E Cox Medical Centers |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760405864 PECOS PAC ID: 8628092897 Enrollment ID: O20060116000342 |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley D Wiley, MD Po Box 9007, Springfield, MO 65808-9007 Ph: (417) 875-3000 | Bradley D Wiley, MD 1001 E Primrose St, Springfield, MO 65807-5155 Ph: (417) 875-3000 |
Mr. Sujan Poudel, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2600 | |
Dr. Mark H. Grimm, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 3231 S National Ave, Springfield, MO 65807 Phone: 417-888-5696 Fax: 417-888-6711 | |
Walter S. Trombold, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 6044 S Overlook Trl, Springfield, MO 65810 Phone: 417-771-5778 | |
Ghulam Jeelani Siddiqui, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2115 S Fremont Ave, Suite 3300, Springfield, MO 65804 Phone: 417-820-5200 Fax: 417-820-5220 | |
Danny R Penick, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3801 S National Ave, Springfield, MO 65807 Phone: 417-269-0000 | |
Dr. Anne Marsh Egbert, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 4630 W Farm Road 82, Springfield, MO 65803 Phone: 417-522-5551 Fax: 417-722-0001 |