| Frederic C Park Iii, MD | |
|
70 Doctors Park, Cape Girardeau, MO 63703-4928 | |
| (573) 334-6071 | |
| (812) 471-6650 |
| Full Name | Frederic C Park Iii |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 48 Years |
| Location | 70 Doctors Park, Cape Girardeau, Missouri |
| 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 |
|---|---|---|---|
| 1821189002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 21342 (Kentucky) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lourdes Hospital | Paducah, KY | Hospital |
| Massac Memorial Hospital | Metropolis, IL | Hospital |
| Anna Hospital Corporation D/b/a Union County Hospital | Anna, IL | Hospital |
| Southern Illinois Hospital Services Dba Herrin Hospital | Herrin, IL | Hospital |
| Memorial Hospital Of Carbondale | Carbondale, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Boone Physician Services Llc | 6507090644 | 246 |
| Cape Radiology Group Pc | 9830093236 | 55 |
| Cape Radiology Group Pc | 9830093236 | 55 |
| Boone Physician Services Llc | 6507090644 | 246 |
| Cape Radiology Group Pc | 9830093236 | 55 |
| Entity Name | Mercy Health Physicians Kentucky Specialty Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700408093 PECOS PAC ID: 1456777069 Enrollment ID: O20200813001096 |
| Entity Name | Cape Radiology Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477506392 PECOS PAC ID: 9830093236 Enrollment ID: O20220624002351 |
| Entity Name | Boone Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760893259 PECOS PAC ID: 6507090644 Enrollment ID: O20240205001129 |
| Mailing Address | Practice Location Address |
|---|---|
| Frederic C Park Iii, MD 70 Doctors Park, Cape Girardeau, MO 63703-4928 Ph: (573) 334-6071 | Frederic C Park Iii, MD 70 Doctors Park, Cape Girardeau, MO 63703-4928 Ph: (573) 334-6071 |
Karen B Willens, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 70 Doctors Park, Cape Girardeau, MO 63703 Phone: 573-335-6671 | |
Jeffrey William Boss, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 70 Doctors Park, Cape Girardeau, MO 63703 Phone: 573-334-6071 Fax: 573-334-4739 | |
Dr. Lance C. Faler, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 70 Doctors Park, Cape Girardeau, MO 63703 Phone: 573-334-6071 | |
Dr. Justin Ray Hodge, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 70 Doctor's Park, Cape Girardeau, MO 63703 Phone: 573-334-6071 Fax: 573-334-4739 | |
Abel Assefa Belay, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 70 Doctors Park, Cape Girardeau, MO 63703 Phone: 573-334-6071 | |
Yuan Yuan Xie, Radiology Medicare: Accepting Medicare Assignments Practice Location: 70 Doctors Park, Cape Girardeau, MO 63703 Phone: 573-334-6071 Fax: 573-334-4739 | |
Dr. George A. Pjura, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 70 Doctors Park, Cape Girardeau, MO 63703 Phone: 573-334-6071 Fax: 573-334-4739 |