| Coral L Couchenour, DO | |
|
104 E. Main Street, Anderson, MO 64831-0750 | |
| (417) 845-6984 | |
| (417) 845-6976 |
| Full Name | Coral L Couchenour |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 23 Years |
| Location | 104 E. Main Street, Anderson, Missouri |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538169131 | NPI | - | NPPES |
| 207361601 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2004017460 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ozarks Community Hospital Of Gravette | Gravette, AR | Hospital |
| Freeman Neosho Hospital | Neosho, MO | Hospital |
| Mercy Hospital Joplin | Joplin, MO | Hospital |
| Freeman Health System - Freeman West | Joplin, MO | Hospital |
| Mercy Hospital Northwest Arkansas | Rogers, AR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sgoh Acquisition Inc | 5092616276 | 94 |
| Entity Name | Sgoh Acquisition Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114924768 PECOS PAC ID: 5092616276 Enrollment ID: O20040205000647 |
| Mailing Address | Practice Location Address |
|---|---|
| Coral L Couchenour, DO Po Box 750, 104 E. Main Street, Anderson, MO 64831-0750 Ph: (417) 845-6984 | Coral L Couchenour, DO 104 E. Main Street, Anderson, MO 64831-0750 Ph: (417) 845-6984 |
Stacy L Jansen, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 510 Park St, Anderson, MO 64831 Phone: 417-845-0545 Fax: 417-845-0548 | |
Dr. Justin Lee Cope, APRN Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 104 W Main St, Anderson, MO 64831 Phone: 417-845-6984 |