| Dr James J Spadaro Jr, MD | |
|
1050 W 10th St, Rolla, MO 65401-2905 | |
| (573) 308-1301 | |
| (573) 202-2480 |
| Full Name | Dr James J Spadaro Jr |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Interventional Cardiology |
| Location | 1050 W 10th St, Rolla, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063411999 | NPI | - | NPPES |
| 10372 | Other | BC/BS ID# | |
| 43-1571021 | Other | TAX ID# | |
| 145792 | Other | HEALTHLINK ID# | |
| 4040796 | Other | AETNA ID# | |
| 202587614 | Medicaid | MO | |
| 8712 | Other | GHP ID# | |
| 202587622 | Medicaid | MO | |
| 2500043 | Other | UHC ID# | |
| 5512255 | Other | CIGNA ID# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0011X | Internal Medicine - Interventional Cardiology | R9324 (Missouri) | Primary |
| Entity Name | Ssm Health Care St Louis |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275586174 PECOS PAC ID: 7810800737 Enrollment ID: O20031118000393 |
| Entity Name | Ssm Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700966207 PECOS PAC ID: 6608776299 Enrollment ID: O20040729001034 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr James J Spadaro Jr, MD 1050 W 10th St, Rolla, MO 65401-2905 Ph: (573) 308-1301 | Dr James J Spadaro Jr, MD 1050 W 10th St, Rolla, MO 65401-2905 Ph: (573) 308-1301 |
Dr. Donald L James, DO Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1050 W 10th St, Rolla, MO 65401 Phone: 573-364-7545 Fax: 573-368-3672 | |
Bohdan A Lebedowicz, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1050 W 10th St, Rolla, MO 65401 Phone: 573-364-9000 Fax: 573-202-2484 | |
Mark Pajeau, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1060 W 10th St, Rolla, MO 65401 Phone: 855-406-3324 Fax: 573-458-8363 | |
John Robertson Carr, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 W 10th St, Rolla, MO 65401 Phone: 573-458-8899 | |
Dr. Dmitry Familtsev, M.D., PH.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1050 W 10th St, Rolla, MO 65401 Phone: 573-308-1301 Fax: 573-202-2480 | |
Ethan James Porter, DO Internal Medicine Medicare: Medicare Enrolled Practice Location: 1000 W 10th St, Rolla, MO 65401 Phone: 573-364-9000 Fax: 573-426-2108 |