| Dr Charles E Woodall Jr, DO | |
|
18598 Highway 13 North, Branson West, MO 65616 | |
| (417) 272-8497 | |
| (417) 272-8496 |
| Full Name | Dr Charles E Woodall Jr |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 18598 Highway 13 North, Branson West, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639252166 | NPI | - | NPPES |
| 241848100 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | R2D64 (Missouri) | Primary |
| Entity Name | Mercy Clinic Springfield Communities |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972771657 PECOS PAC ID: 7416865845 Enrollment ID: O20031218000354 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Charles E Woodall Jr, DO Po Box 2580, Springfield, MO 65801-2580 Ph: (417) 829-4620 | Dr Charles E Woodall Jr, DO 18598 Highway 13 North, Branson West, MO 65616 Ph: (417) 272-8497 |
Elizabeth J Ballard, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 18452 Business 13, Branson West, MO 65737 Phone: 417-272-8911 Fax: 417-272-3900 | |
Dr. Thomas J Legg, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 18452 Business 13, Branson West, MO 65737 Phone: 417-272-8911 | |
Dr. Matthew L Cobb, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 18452 Business 13, Branson West, MO 65737 Phone: 417-292-8911 Fax: 417-272-3900 | |
Dr. Timothy L. Kinzie, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 18598 Highway 13 North, Branson West, MO 65737 Phone: 417-272-8497 Fax: 417-272-8496 | |
Sami Houssin Hourieh, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 18598 Business 13, Branson West, MO 65737 Phone: 417-272-8497 |