| Dr Trina J Blythe, MD | |
|
20 Progress Point Pkwy Ste 100, O Fallon, MO 63368-2207 | |
| (636) 344-2213 | |
| Not Available |
| Full Name | Dr Trina J Blythe |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 20 Progress Point Pkwy Ste 100, O Fallon, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316080559 | NPI | - | NPPES |
| 122086 | Other | MO | BLUE CROSS BLUE SHIELD ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 119707 (Missouri) | Primary |
| Entity Name | Physician Groups Lc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285664268 PECOS PAC ID: 3072421254 Enrollment ID: O20040220001157 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Trina J Blythe, MD 20 Progress Point Pkwy Ste 100, O Fallon, MO 63368-2207 Ph: () - | Dr Trina J Blythe, MD 20 Progress Point Pkwy Ste 100, O Fallon, MO 63368-2207 Ph: (636) 344-2213 |
Dr. Cecilia H Yu, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 20 Progress Point Pkwy, Ste 220, O Fallon, MO 63368 Phone: 636-344-3333 Fax: 636-344-3334 | |
Kimberly N Hackney, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Winding Woods Dr Ste 120, O Fallon, MO 63366 Phone: 636-978-7902 | |
Jasmine Kaur, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Winding Woods Dr Ste 120, O Fallon, MO 63366 Phone: 636-978-7902 | |
Dr. Yasangi Marina Jayasinha, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1001 Highway K, Suite 4, O Fallon, MO 63366 Phone: 636-240-9896 | |
Dr. John A Myers, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 20 Progress Point Pkwy, Ste 220, O Fallon, MO 63368 Phone: 636-344-3333 Fax: 636-344-3334 | |
Dr. Phillip D Reichert, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 20 Progress Point Pkwy, Ste 220, O Fallon, MO 63368 Phone: 636-344-3333 Fax: 636-344-3334 |