| Dr Jeffrey O'banner, MD | |
|
4250 Bethel Rd, Olive Branch, MS 38654-8737 | |
| (662) 932-9000 | |
| Not Available |
| Full Name | Dr Jeffrey O'banner |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 10 Years |
| Location | 4250 Bethel Rd, Olive Branch, Mississippi |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801277363 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 31799 (Mississippi) | Primary |
| 207Q00000X | Family Medicine | 31799 (Mississippi) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Northwest Mississippi Medical Center | Clarksdale, MS | Hospital |
| Methodist Healthcare - Olive Branch Hospital | Olive branch, MS | Hospital |
| Tishomingo Health Services Inc | Iuka, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Tishomingo Health Services, Inc. | 2466354303 | 15 |
| Olive Branch Emergency Physicians Llc | 9335598739 | 25 |
| Entity Name | Tishomingo Health Services, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548376700 PECOS PAC ID: 2466354303 Enrollment ID: O20040122000374 |
| Entity Name | Correct Care, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215987441 PECOS PAC ID: 8628980992 Enrollment ID: O20131122000662 |
| Entity Name | Yazoo Emergency Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447806914 PECOS PAC ID: 0749511574 Enrollment ID: O20191009002380 |
| Entity Name | Olive Branch Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730969734 PECOS PAC ID: 9335598739 Enrollment ID: O20231211002611 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jeffrey O'banner, MD 180 S 3rd St, Suite 300, Belleville, IL 62220-1952 Ph: (618) 333-5480 | Dr Jeffrey O'banner, MD 4250 Bethel Rd, Olive Branch, MS 38654-8737 Ph: (662) 932-9000 |