| Suckhong Brian Kim, MD | |
|
1540 E Evergreen St, Springfield, MO 65803-4300 | |
| (417) 823-2900 | |
| (417) 886-2774 |
| Full Name | Suckhong Brian Kim |
|---|---|
| Gender | Male |
| Speciality | Pulmonary Disease |
| Experience | 39 Years |
| Location | 1540 E Evergreen St, Springfield, 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 |
|---|---|---|---|
| 1922041839 | NPI | - | NPPES |
| 039014838 | Medicaid | MO | |
| 202657011 | Medicaid | MO | |
| P00958203 | Other | AR | RR MEDICARE |
| 1922041839 | Medicaid | MO | |
| 107067 | Other | BLUE CROSS/BLUE SHIELD | |
| 188306001 | Medicaid | AR | |
| P00361138 | Other | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RP1001X | Internal Medicine - Pulmonary Disease | R5J91 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Citizens Memorial Hospital | Bolivar, MO | Hospital |
| Ozarks Community Hospital Of Gravette | Gravette, AR | Hospital |
| Cox Medical Centers | Springfield, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Citizens Memorial Healthcare | 4183528169 | 108 |
| Sgoh Acquisition Inc | 5092616276 | 74 |
| Sgoh Acquisition Inc | 5092616276 | 74 |
| Entity Name | Sgoh Acquisition Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114924768 PECOS PAC ID: 5092616276 Enrollment ID: O20040205000647 |
| Entity Name | Citizens Memorial Healthcare |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568566131 PECOS PAC ID: 4183528169 Enrollment ID: O20040315001374 |
| Mailing Address | Practice Location Address |
|---|---|
| Suckhong Brian Kim, MD 1540 E Evergreen St, Springfield, MO 65803-4300 Ph: (417) 823-2900 | Suckhong Brian Kim, MD 1540 E Evergreen St, Springfield, MO 65803-4300 Ph: (417) 823-2900 |
Mr. Sujan Poudel, M.D. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2600 | |
Dr. Mark H. Grimm, MD Pulmonary Disease Medicare: Medicare Enrolled Practice Location: 3231 S National Ave, Springfield, MO 65807 Phone: 417-888-5696 Fax: 417-888-6711 | |
Bradley D Wiley, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 1001 E Primrose St, Springfield, MO 65807 Phone: 417-875-3000 Fax: 417-875-3051 | |
Walter S. Trombold, MD Pulmonary Disease Medicare: Not Enrolled in Medicare Practice Location: 6044 S Overlook Trl, Springfield, MO 65810 Phone: 417-771-5778 | |
Ghulam Jeelani Siddiqui, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 2115 S Fremont Ave, Suite 3300, Springfield, MO 65804 Phone: 417-820-5200 Fax: 417-820-5220 | |
Danny R Penick, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 3801 S National Ave, Springfield, MO 65807 Phone: 417-269-0000 | |
Dr. Anne Marsh Egbert, M.D. Pulmonary Disease Medicare: Not Enrolled in Medicare Practice Location: 4630 W Farm Road 82, Springfield, MO 65803 Phone: 417-522-5551 Fax: 417-722-0001 |