| Dr John Jacob Long, DO | |
|
2 Progress Point Pkwy, Dept Anesthesiology, O Fallon, MO 63368-2205 | |
| (800) 862-9980 | |
| (314) 362-1185 |
| Full Name | Dr John Jacob Long |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 33 Years |
| Location | 2 Progress Point Pkwy, O Fallon, 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 |
|---|---|---|---|
| 1063442648 | NPI | - | NPPES |
| 209326909 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 2004020474 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Carolina East Medical Center | New bern, NC | Hospital |
| Missouri Baptist Medical Center | Town and country, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southeast Anesthesiology Consultants Pllc | 7719959873 | 92 |
| Missouri Baptist Medical Center | 3476461955 | 123 |
| Entity Name | Southeast Anesthesiology Consultants PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538124201 PECOS PAC ID: 7719959873 Enrollment ID: O20040809001398 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr John Jacob Long, DO Po Box 7412011, Chicago, IL 60674-2011 Ph: (800) 862-9980 | Dr John Jacob Long, DO 2 Progress Point Pkwy, Dept Anesthesiology, O Fallon, MO 63368-2205 Ph: (800) 862-9980 |
Dr. Chakrapol Lattanand, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2 Progress Point Pkwy, Dept Anesthesiology, O Fallon, MO 63368 Phone: 800-862-9980 Fax: 314-362-1185 |
Dr. Sunita Dharmavarapu, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 2 Progress Point Ct, O Fallon, MO 63368 Phone: 314-286-1050 Fax: 314-344-1138 |
Dr. David A Friedman, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 2 Progress Point Ct, O Fallon, MO 63368 Phone: 636-344-1170 Fax: 636-344-1138 |
Vivek K Manchanda, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 4122 Keaton Crossing Blvd, Suite 102, O Fallon, MO 63368 Phone: 636-329-9077 Fax: 636-329-9076 |
Dr. Jessica Lauren Sanford, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2 Progress Point Pkwy, Dept Anesthesiology, O Fallon, MO 63368 Phone: 800-862-9980 Fax: 314-362-1185 |
Dr. Victor Xia Qi, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2 Progress Point Pkwy, Dept Anesthesiology, O Fallon, MO 63368 Phone: 800-862-9980 Fax: 314-362-1185 |
Dr. Isabella Rossi Riordan, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2 Progress Point Pkwy, Dept Anesthesiology, O Fallon, MO 63368 Phone: 800-862-9980 Fax: 314-362-1185 |