| Dr Justin Daniel Terrell, MD | |
|
401 N Main St, Gravois Mills, MO 65037-6253 | |
| (877) 406-2662 | |
| (573) 207-2773 |
| Full Name | Dr Justin Daniel Terrell |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 401 N Main St, Gravois Mills, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689986275 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2013026811 (Missouri) | Primary |
| Entity Name | State Of Missouri |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164477873 PECOS PAC ID: 1456254226 Enrollment ID: O20040129000481 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Justin Daniel Terrell, MD 401 N Main St, Gravois Mills, MO 65037-6253 Ph: (877) 406-2662 | Dr Justin Daniel Terrell, MD 401 N Main St, Gravois Mills, MO 65037-6253 Ph: (877) 406-2662 |
Kenneth L Derrington, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 156 Missouri Blvd Ste B, Gravois Mills, MO 65037 Phone: 573-374-5263 Fax: 573-374-4933 | |
Brandon C.w. Brown, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 156 Missouri Blvd, Gravois Mills, MO 65037 Phone: 573-374-5263 Fax: 573-374-4933 | |
Dr. Elizabeth Nichole Bowman, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 401 N Main St, Gravois Mills, MO 65037 Phone: 877-406-2662 |