| John Fuller, MD | |
|
1000 E Cherry St, Troy, MO 63379-1513 | |
| (636) 528-8551 | |
| Not Available |
| Full Name | John Fuller |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 34 Years |
| Location | 1000 E Cherry St, Troy, 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 |
|---|---|---|---|
| 1093754574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 112096 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy Hospital Lincoln | Troy, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mercy Aco Clinical Services Inc | 6901188572 | 113 |
| Entity Name | Mercy Hospital South |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568481984 PECOS PAC ID: 8426962556 Enrollment ID: O20031113000592 |
| Entity Name | Southeastern Emergency Physicians Of Memphis Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437105277 PECOS PAC ID: 5395643209 Enrollment ID: O20060711000434 |
| Entity Name | Cep America Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619332046 PECOS PAC ID: 6608056171 Enrollment ID: O20150312000325 |
| Entity Name | Mercy Hospital Lincoln |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962808733 PECOS PAC ID: 5193040020 Enrollment ID: O20150623002541 |
| Entity Name | Mercy Aco Clinical Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063965093 PECOS PAC ID: 6901188572 Enrollment ID: O20170117001888 |
| Mailing Address | Practice Location Address |
|---|---|
| John Fuller, MD 10010 Kennerly Rd, Saint Louis, MO 63128-2106 Ph: (314) 525-1900 | John Fuller, MD 1000 E Cherry St, Troy, MO 63379-1513 Ph: (636) 528-8551 |
Timothy Mccullough, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1000 E Cherry St, Troy, MO 63379 Phone: 636-528-3221 | |
Pamela Westerling, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 230 Tompkins Court, Troy, MO 63379 Phone: 708-422-4221 Fax: 708-422-4415 |