| Dr Jeremy Glynn Light, MD | |
|
109 Pinehurst Dr, Branson, MO 65616-2796 | |
| (417) 888-0858 | |
| (417) 889-0476 |
| Full Name | Dr Jeremy Glynn Light |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Experience | 6 Years |
| Location | 109 Pinehurst Dr, Branson, Missouri |
| 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 |
|---|---|---|---|
| 1831727718 | NPI | - | NPPES |
| 200098794 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 2023049376 (Missouri) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 2023049376 (Missouri) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Phelan Dermatology And Aesthetics | 9234538331 | 2 |
| Entity Name | Washington University |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992746903 PECOS PAC ID: 9830008770 Enrollment ID: O20031119000372 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jeremy Glynn Light, MD 801 York St, Manitowoc, WI 54220-4630 Ph: (920) 663-9008 | Dr Jeremy Glynn Light, MD 109 Pinehurst Dr, Branson, MO 65616-2796 Ph: (417) 888-0858 |
Dr. Douglas Michael Leone, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 110 Business Park Dr Ste C, Branson, MO 65616 Phone: 417-336-0033 Fax: 309-452-3376 | |
Amy R Thorne, DO Dermatology Medicare: Medicare Enrolled Practice Location: 110 Business Park Dr Ste C, Branson, MO 65616 Phone: 417-336-0033 | |
Dr. Christy Shaffer Rainey, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 110 Business Park Dr, Ste C, Branson, MO 65616 Phone: 417-239-0125 Fax: 417-239-0127 |