| John D Despain, MD | |
|
5721 Osage Beach Pkwy Ste 100, Osage Beach, MO 65065-3030 | |
| (573) 302-4696 | |
| (573) 302-4698 |
| Full Name | John D Despain |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Experience | 42 Years |
| Location | 5721 Osage Beach Pkwy Ste 100, Osage Beach, 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 |
|---|---|---|---|
| 1932196433 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ND0900X | Dermatology - Dermatopathology | R8E64 (Missouri) | Secondary |
| 207N00000X | Dermatology | R8E64 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lake Regional Health System | Osage beach, MO | Hospital |
| Bothwell Regional Health Center | Sedalia, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Forefront Dermatology Sc | 3779471701 | 641 |
| Entity Name | Jefferson City Medical Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336189398 PECOS PAC ID: 1850371089 Enrollment ID: O20040908000924 |
| Entity Name | Boyce & Bynum Pathology Professional Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689634818 PECOS PAC ID: 0042384976 Enrollment ID: O20080811000335 |
| Entity Name | Forefront Dermatology Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891179040 PECOS PAC ID: 3779471701 Enrollment ID: O20150922001275 |
| Mailing Address | Practice Location Address |
|---|---|
| John D Despain, MD 801 York St, Manitowoc, WI 54220-4630 Ph: (920) 663-9008 | John D Despain, MD 5721 Osage Beach Pkwy Ste 100, Osage Beach, MO 65065-3030 Ph: (573) 302-4696 |
Karen L Eshraghi, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 54 Hospital Dr Ste 203, Osage Beach, MO 65065 Phone: 573-302-4695 |