| Roger Kingsley Bost, MD | |
|
686 Lester St, Poplar Bluff, MO 63901 | |
| (573) 686-2411 | |
| (573) 686-8452 |
| Full Name | Roger Kingsley Bost |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 686 Lester St, Poplar Bluff, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881672418 | NPI | - | NPPES |
| 103885001 | Medicaid | AR | |
| 203450408 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 101937 (Missouri) | Primary |
| Entity Name | Missouri Delta Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508967860 PECOS PAC ID: 1355252891 Enrollment ID: O20040308001306 |
| Mailing Address | Practice Location Address |
|---|---|
| Roger Kingsley Bost, MD Po Box 220, Poplar Bluff, MO 63902 Ph: (573) 686-2411 | Roger Kingsley Bost, MD 686 Lester St, Poplar Bluff, MO 63901 Ph: (573) 686-2411 |
Sushmita Thota, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2879 James Blvd, Poplar Bluff, MO 63901 Phone: 214-566-8275 | |
Dr. Rangsan Suvan, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2500 Lucy Lee Parkway, Poplar Bluff, MO 63901 Phone: 573-686-2585 Fax: 573-686-4415 | |
Dr. Claudia Karin Preuschoff, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901 Phone: 573-727-5500 Fax: 573-727-5599 | |
Gift Adanma Onyenso, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901 Phone: 573-727-5500 Fax: 573-727-5599 | |
Dr. Debra Ann Robertson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901 Phone: 573-727-5500 Fax: 573-727-5599 | |
Mr. Joseph P Fernando, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2340 Katy Ln, Suite 120, Poplar Bluff, MO 63901 Phone: 573-776-7393 Fax: 573-776-7396 | |
Dr. Shaun A Ross, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901 Phone: 573-727-5500 Fax: 573-727-5599 |