| Dr Alexandros Georgolios, MD | |
|
3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | |
| (573) 778-2600 | |
| Not Available |
| Full Name | Dr Alexandros Georgolios |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Location | 3100 Oak Grove Rd, Poplar Bluff, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053571794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | TP526 (Kentucky) | Secondary |
| 207Y00000X | Otolaryngology | 2013045551 (Missouri) | Primary |
| Entity Name | Poplar Bluff Hma Physician Management, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598710147 PECOS PAC ID: 5092769703 Enrollment ID: O20050307000013 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Alexandros Georgolios, MD 79 Venizelou Street, Holargos, ATTIKI 15561 Ph: (012) 106-545443 | Dr Alexandros Georgolios, MD 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 Ph: (573) 778-2600 |
Dr. Suwan Phanijphand, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 2011 N Westwood Blvd, Poplar Bluff, MO 63901 Phone: 573-785-7791 Fax: 573-785-8784 |
Carl Eugene Bosley, D.O. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 2503 Lucy Lee Pkwy, Poplar Bluff, MO 63901 Phone: 573-785-5544 Fax: 573-785-4672 |