| Michael Scott Severance, MD | |
|
3207 W Truman Blvd, Jefferson City, MO 65109-0578 | |
| (573) 636-5115 | |
| (573) 636-2818 |
| Full Name | Michael Scott Severance |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 38 Years |
| Location | 3207 W Truman Blvd, Jefferson City, Missouri |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790708907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 101963 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lake Regional Health System | Osage beach, MO | Hospital |
| University Of Missouri Health Care | Columbia, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lake Regional Medical Management Inc | 3577467323 | 45 |
| Lake Regional Health System | 9133026776 | 114 |
| Entity Name | Lake Regional Medical Management Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639134158 PECOS PAC ID: 3577467323 Enrollment ID: O20031122000076 |
| Entity Name | Lake Regional Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053581454 PECOS PAC ID: 9133026776 Enrollment ID: O20070511000147 |
| Entity Name | Urology Care, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780723205 PECOS PAC ID: 4688630718 Enrollment ID: O20070703000252 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Scott Severance, MD 3207 W Truman Blvd, Jefferson City, MO 65109-0578 Ph: (573) 636-5115 | Michael Scott Severance, MD 3207 W Truman Blvd, Jefferson City, MO 65109-0578 Ph: (573) 636-5115 |
Eric Ivan Vogt, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 3207 W Truman Blvd, Jefferson City, MO 65109 Phone: 573-636-5115 | |
Douglas Alan West, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 3207 W Truman Blvd, Jefferson City, MO 65109 Phone: 573-636-5115 Fax: 573-636-2818 | |
John Paul Koonce, MD Urology Medicare: Medicare Enrolled Practice Location: 3207 W Truman Blvd, Jefferson City, MO 65109 Phone: 573-636-5115 Fax: 573-636-2818 | |
Dr. Jerry Jeff Trulson, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 3207 W Truman Blvd, Jefferson City, MO 65109 Phone: 573-636-5115 Fax: 573-636-2818 |