| Keith J Odegard, MD | |
|
12855 North Forty Drive, Suite 125, St. Louis, MO 63141 | |
| (314) 966-0111 | |
| (314) 966-1023 |
| Full Name | Keith J Odegard |
|---|---|
| Gender | Male |
| Speciality | Orthopedic Surgery |
| Experience | 41 Years |
| Location | 12855 North Forty Drive, St. Louis, 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 |
|---|---|---|---|
| 1083609614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 2004027795 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy Hospital St Louis | Saint louis, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mercy Clinic Surgical Specialists Llc | 1153455076 | 149 |
| Physical Therapy Spine And Sports Medicine Llc | 3173654936 | 100 |
| Entity Name | Mercy Hospitals East Communities |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851431738 PECOS PAC ID: 1658276811 Enrollment ID: O20031218000107 |
| Entity Name | Mercy Clinic Surgical Specialists Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043530538 PECOS PAC ID: 1153455076 Enrollment ID: O20100813001038 |
| Mailing Address | Practice Location Address |
|---|---|
| Keith J Odegard, MD 12813 Flushing Meadows Drive, Suite 210, St. Louis, MO 63131 Ph: (314) 966-0111 | Keith J Odegard, MD 12855 North Forty Drive, Suite 125, St. Louis, MO 63141 Ph: (314) 966-0111 |
Husam T Nawas, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 12855 North Forty Drive, Suite 125, North Tower, St. Louis, MO 63141 Phone: 314-966-0111 Fax: 314-966-2810 | |
Mrs. Margaret Mary Rich, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 2001 South Lindbergh Boulevard, St. Louis, MO 63131 Phone: 314-432-3600 Fax: 314-872-7808 | |
Jay Patel, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 425 North New Ballas Road, Suite 230, St. Louis, MO 63141 Phone: 314-266-2066 Fax: 314-266-2069 | |
Michael P. Nogalski, M.D. Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 1050 Old Des Peres Rd., Suite 100, St. Louis, MO 63131 Phone: 314-569-0612 Fax: 314-966-0664 | |
Daemeon Achilles Nicolaou, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 3635 Vista Ave, 7th Floor Desloge Towers, St. Louis, MO 63110 Phone: 314-577-8850 Fax: 314-268-5121 | |
Dr. Micah Christian Hobbs, D.O. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 425 North New Ballas Road, Suite 230, St. Louis, MO 63141 Phone: 314-266-2066 Fax: 314-266-2069 |