| Dr Mark H Grimm, MD | |
|
3231 S National Ave, Springfield, MO 65807-7304 | |
| (417) 888-5696 | |
| (417) 888-6711 |
| Full Name | Dr Mark H Grimm |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Pulmonary Disease |
| Location | 3231 S National Ave, Springfield, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003967696 | NPI | - | NPPES |
| 206653412 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RP1001X | Internal Medicine - Pulmonary Disease | 103150 (Missouri) | Primary |
| Entity Name | Mercy Clinic Springfield Communities |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972771657 PECOS PAC ID: 7416865845 Enrollment ID: O20031218000354 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark H Grimm, MD Po Box 2580, Springfield, MO 65801-2580 Ph: (417) 829-4620 | Dr Mark H Grimm, MD 3231 S National Ave, Springfield, MO 65807-7304 Ph: (417) 888-5696 |
Mr. Sujan Poudel, M.D. Pulmonary Disease Medicare: Medicare Enrolled Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2600 | |
Bradley D Wiley, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 1001 E Primrose St, Springfield, MO 65807 Phone: 417-875-3000 Fax: 417-875-3051 | |
Walter S. Trombold, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 6044 S Overlook Trl, Springfield, MO 65810 Phone: 417-771-5778 | |
Ghulam Jeelani Siddiqui, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 2115 S Fremont Ave, Suite 3300, Springfield, MO 65804 Phone: 417-820-5200 Fax: 417-820-5220 | |
Danny R Penick, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 3801 S National Ave, Springfield, MO 65807 Phone: 417-269-0000 | |
Dr. Anne Marsh Egbert, M.D. Pulmonary Disease Medicare: Not Enrolled in Medicare Practice Location: 4630 W Farm Road 82, Springfield, MO 65803 Phone: 417-522-5551 Fax: 417-722-0001 |