| Dr Jacob C Marshall Jr, MD | |
|
103 N Oak St, O Fallon, IL 62269-1165 | |
| (888) 577-6337 | |
| Not Available |
| Full Name | Dr Jacob C Marshall Jr |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 103 N Oak St, O Fallon, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922081249 | NPI | - | NPPES |
| 036102192 | Medicaid | IL | |
| 1922081249 | Medicaid | MO | |
| 08232204 | Other | IL | BLUE CROSS BLUE SHIELD |
| 036102192 -8 | Medicaid | IL | |
| 036102192-9 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 036-102192 (Illinois) | Secondary |
| 207Q00000X | Family Medicine | 036102192 (Illinois) | Primary |
| Entity Name | Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851390132 PECOS PAC ID: 5294649372 Enrollment ID: O20031113000382 |
| Entity Name | Memorial Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1851390132 PECOS PAC ID: 5294649372 Enrollment ID: O20080529000078 |
| Entity Name | Midwest Emergency Good Samaritan, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629367578 PECOS PAC ID: 1658529342 Enrollment ID: O20120921000645 |
| Entity Name | Midwest Emergency Sparta, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194162370 PECOS PAC ID: 0345481255 Enrollment ID: O20130718000343 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jacob C Marshall Jr, MD 2200 Bowler Rd, Collinsville, IL 62234-7012 Ph: (618) 977-9607 | Dr Jacob C Marshall Jr, MD 103 N Oak St, O Fallon, IL 62269-1165 Ph: (888) 577-6337 |
Dr. Noah M Cooperstein, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 3 Saint Elizabeth Blvd Ste 4000, O Fallon, IL 62269 Phone: 618-256-7311 |
Dr. Patrick Bloecher, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3 Saint Elizabeth Blvd Ste 4000, O Fallon, IL 62269 Phone: 618-233-7880 |
Dr. Steven Allen Taylor, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1512 N Green Mount Rd Ste 108, O Fallon, IL 62269 Phone: 618-624-5510 Fax: 618-624-5529 |
Dr. Vincent Joseph Duenas, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Saint Elizabeth Blvd, O Fallon, IL 62269 Phone: 618-234-2120 |
Rema Sanghavi, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1512 N Green Mount Rd Ste 108, O Fallon, IL 62269 Phone: 618-624-5510 Fax: 618-624-5529 |
Dr. John Michael Kaschke, MD Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 670 Pierce Blvd, O Fallon, IL 62269 Phone: 618-206-2070 Fax: 618-206-2071 |
Dr. Kaleb George Kremsreiter, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 3 Saint Elizabeth Blvd Ste 4000, O Fallon, IL 62269 Phone: 618-222-4600 |