| Jacob Graham Lanter, | |
|
739 N Jefferson St, Mascoutah, IL 62258-1447 | |
| (618) 566-8810 | |
| Not Available |
| Full Name | Jacob Graham Lanter |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 739 N Jefferson St, Mascoutah, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417419714 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036161533 (Illinois) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| Entity Name | Rural Family Medicine Associates Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366639759 PECOS PAC ID: 2264489038 Enrollment ID: O20050404000800 |
| Entity Name | Lincoln Surgical Associates, Ltd. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861706814 PECOS PAC ID: 9335320597 Enrollment ID: O20110221000715 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Graham Lanter, 739 N Jefferson St, Mascoutah, IL 62258-1447 Ph: (618) 566-8810 | Jacob Graham Lanter, 739 N Jefferson St, Mascoutah, IL 62258-1447 Ph: (618) 566-8810 |
Paul J Reger, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 739 N Jefferson St, Suite 200, Mascoutah, IL 62258 Phone: 618-566-8810 Fax: 618-566-7121 | |
Steven D Pritchett, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 739 N Jefferson St, Suite 200, Mascoutah, IL 62258 Phone: 618-566-8810 Fax: 618-566-7121 | |
Judith K Weis, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 739 N Jefferson St, Suite 200, Mascoutah, IL 62258 Phone: 618-566-8810 Fax: 618-566-7121 |