| Dr Pairote Jaroonwanichkul, MD | |
|
1723 Broadway St, Suite 315, Cape Girardeau, MO 63701-4505 | |
| (573) 331-6476 | |
| (573) 331-6526 |
| Full Name | Dr Pairote Jaroonwanichkul |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Hematology & Oncology |
| Location | 1723 Broadway St, Cape Girardeau, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801893979 | NPI | - | NPPES |
| 203568217 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RH0003X | Internal Medicine - Hematology & Oncology | 036084741 (Illinois) | Secondary |
| 207RH0003X | Internal Medicine - Hematology & Oncology | 102149 (Missouri) | Primary |
| Entity Name | Southern Illinois Medical Services Nfp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595 |
| Entity Name | Mendota Community Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1609803113 PECOS PAC ID: 2264335777 Enrollment ID: O20080123000489 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Pairote Jaroonwanichkul, MD 3655 Vista Ave, Saint Louis, MO 63110-2539 Ph: (314) 977-4340 | Dr Pairote Jaroonwanichkul, MD 1723 Broadway St, Suite 315, Cape Girardeau, MO 63701-4505 Ph: (573) 331-6476 |
Kenneth W Retter, MD Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 211 Saint Francis Dr Ste 15, Cape Girardeau, MO 63703 Phone: 573-331-3333 | |
Mariam Aehtesham, Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 1701 Lacey St, Cape Girardeau, MO 63701 Phone: 573-334-4822 Fax: 573-986-5984 | |
Dr. Aaron Lang, M.D. Hematology & Oncology Medicare: Not Enrolled in Medicare Practice Location: 1723 Broadway St, Suite 315, Cape Girardeau, MO 63701 Phone: 573-332-0226 Fax: 573-332-0344 | |
Philip W Taylor, M.D., FACP Hematology & Oncology Medicare: Not Enrolled in Medicare Practice Location: 3250 Gordonville Rd, Ste 301, Cape Girardeau, MO 63703 Phone: 573-334-9641 Fax: 573-331-3120 | |
Jacob M Burch, DO Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 28 S Mount Auburn Rd, Cape Girardeau, MO 63703 Phone: 573-331-3350 Fax: 573-331-3351 | |
Tibebe Haile, M.D. Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 1701 Lacey St, Cape Girardeau, MO 63701 Phone: 573-331-6431 Fax: 573-986-5984 | |
Dr. Tiffany Renae Samples, DO Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 211 Saint Francis Dr, Cape Girardeau, MO 63703 Phone: 573-331-5770 Fax: 573-331-3974 |