| Randall Bruce Clark Ii, DO | |
|
70 Doctors Park, Cape Girardeau, MO 63703-4928 | |
| (573) 334-6071 | |
| (573) 334-4739 |
| Full Name | Randall Bruce Clark Ii |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 12 Years |
| Location | 70 Doctors Park, Cape Girardeau, 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 |
|---|---|---|---|
| 1265873111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 2013021199 (Missouri) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Premier Diagnostic Imaging, Llc | 4981877784 | 3 |
| Entity Name | Premier Diagnostic Imaging, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730130345 PECOS PAC ID: 4981877784 Enrollment ID: O20111021000422 |
| Mailing Address | Practice Location Address |
|---|---|
| Randall Bruce Clark Ii, DO 70 Doctors Park, Cape Girardeau, MO 63703-4928 Ph: (573) 334-6071 | Randall Bruce Clark Ii, DO 70 Doctors Park, Cape Girardeau, MO 63703-4928 Ph: (573) 334-6071 |
Karen B Willens, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 70 Doctors Park, Cape Girardeau, MO 63703 Phone: 573-335-6671 | |
Jeffrey William Boss, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 70 Doctors Park, Cape Girardeau, MO 63703 Phone: 573-334-6071 Fax: 573-334-4739 | |
Dr. Lance C. Faler, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 70 Doctors Park, Cape Girardeau, MO 63703 Phone: 573-334-6071 | |
Dr. Justin Ray Hodge, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 70 Doctor's Park, Cape Girardeau, MO 63703 Phone: 573-334-6071 Fax: 573-334-4739 | |
Abel Assefa Belay, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 70 Doctors Park, Cape Girardeau, MO 63703 Phone: 573-334-6071 | |
Yuan Yuan Xie, Radiology Medicare: Accepting Medicare Assignments Practice Location: 70 Doctors Park, Cape Girardeau, MO 63703 Phone: 573-334-6071 Fax: 573-334-4739 | |
Dr. George A. Pjura, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 70 Doctors Park, Cape Girardeau, MO 63703 Phone: 573-334-6071 Fax: 573-334-4739 |