| Dr Sean David Lattimore, DO | |
|
1000 Eleven S Ste 4a, Columbia, IL 62236-1077 | |
| (618) 206-6120 | |
| Not Available |
| Full Name | Dr Sean David Lattimore |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 28 Years |
| Location | 1000 Eleven S Ste 4a, Columbia, Illinois |
| 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 |
|---|---|---|---|
| 1710058961 | NPI | - | NPPES |
| P00429608 | Other | MEDICARE RR | |
| 036102258 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036102258 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ssm St Clare Health Center | Fenton, MO | Hospital |
| Gateway Regional Medical Center | Granite city, IL | Hospital |
| Red Bud Regional Hospital | Red bud, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ssm Medical Group Inc | 6608776299 | 500 |
| Ssm Medical Group Inc | 6608776299 | 500 |
| Entity Name | Integritas Emergency Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790128817 PECOS PAC ID: 7113167446 Enrollment ID: O20130710000760 |
| Entity Name | Ssm Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700966207 PECOS PAC ID: 6608776299 Enrollment ID: O20150929002491 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Sean David Lattimore, DO Po Box 955534, Saint Louis, MO 63195-5534 Ph: () - | Dr Sean David Lattimore, DO 1000 Eleven S Ste 4a, Columbia, IL 62236-1077 Ph: (618) 206-6120 |
Carrie A Daigle, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1019 Valmeyer Rd, Columbia, IL 62236 Phone: 618-205-7170 Fax: 618-205-7171 | |
Kelly Ann Wood, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 420 Columbia Ctr, Columbia, IL 62236 Phone: 618-791-2011 Fax: 618-417-6046 | |
Michael Nels Kirk, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Eleven S Ste 4a, Columbia, IL 62236 Phone: 618-206-6120 |