| Dr Rebecca J Wotherspoon, MD | |
| 222 E Primrose St, Suite E, Springfield, MO 65807-5206 | |
| (417) 553-1080 | |
| (888) 712-7702 | 
| Full Name | Dr Rebecca J Wotherspoon | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 222 E Primrose St, 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 | 
|---|---|---|---|
| 1801984497 | NPI | - | NPPES | 
| 200014010B | Medicaid | OK | |
| 202710364 | Medicaid | MO | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 102581 (Missouri) | Secondary | 
| 208000000X | Pediatrics | 29631 (Oklahoma) | Primary | 
| Entity Name | Elite Pain Management Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1609257773 PECOS PAC ID: 2062724602 Enrollment ID: O20150814014362 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Rebecca J Wotherspoon, MD 101 S Park Ln, Altus, OK 73521-5731 Ph: (580) 379-6100 | Dr Rebecca J Wotherspoon, MD 222 E Primrose St, Suite E, Springfield, MO 65807-5206 Ph: (417) 553-1080 | 
| Dr. Alan Dare Tong, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 4350 S National Ave, Suite C 100, Springfield, MO 65810 Phone: 417-447-4700 Fax: 417-447-4701 | |
| Quinton Alexander Barnes,  Pediatrics Medicare: Medicare Enrolled Practice Location: 3253 E Chestnut Expy Ste 210a, Springfield, MO 65802 Phone: 417-885-2200 | |
| Michael Stephen Hanks, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1000 E Primrose, Ste 320, Springfield, MO 65807 Phone: 417-269-2300 Fax: 417-269-2315 | |
| Matthew C Lundien, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1965 S Fremont Ave, Ste 220, Springfield, MO 65804 Phone: 417-820-9055 | |
| Dr. Melinda Rae Slack, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-3219 | |
| Brittany Nicole Montavon, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3801 S National Ave, Springfield, MO 65807 Phone: 417-269-6184 Fax: 417-269-4608 | |
| Nicole Marie Kucera, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3443 S National Ave, Springfield, MO 65807 Phone: 417-269-2000 Fax: 417-269-2038 |