| Brent D Speak, DO | |
|
402 W Jefferson St, Kirksville, MO 63501-3407 | |
| (660) 665-3555 | |
| (660) 665-3547 |
| Full Name | Brent D Speak |
|---|---|
| Gender | Male |
| Speciality | Obstetrics/gynecology |
| Experience | 21 Years |
| Location | 402 W Jefferson St, Kirksville, 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 |
|---|---|---|---|
| 1063681419 | NPI | - | NPPES |
| 503351801 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 2009006697 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Northeast Regional Medical Center | Kirksville, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Northeast Missouri Health Council Inc | 1658280805 | 20 |
| Entity Name | Northeast Missouri Health Council Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104829498 PECOS PAC ID: 1658280805 Enrollment ID: O20040112000061 |
| Entity Name | Northeast Missouri Health Council Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104829498 PECOS PAC ID: 1658280805 Enrollment ID: O20040430000892 |
| Mailing Address | Practice Location Address |
|---|---|
| Brent D Speak, DO 1416 Crown Dr, Kirksville, MO 63501-2548 Ph: (660) 627-5757 | Brent D Speak, DO 402 W Jefferson St, Kirksville, MO 63501-3407 Ph: (660) 665-3555 |
Melodie Dawn Stocks, DO Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 402 W Jefferson St, Kirksville, MO 63501 Phone: 660-665-3555 Fax: 660-665-3547 | |
Mr. Ralph O Boling Jr., D.O. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 1605 South Baltimore Street, Suite B, Kirksville, MO 63501 Phone: 660-956-7279 Fax: 660-665-3570 |