| Stephen Larson, MD | |
|
12303 De Paul Dr, Bridgeton, MO 63044-2512 | |
| (314) 344-6000 | |
| Not Available |
| Full Name | Stephen Larson |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 12303 De Paul Dr, Bridgeton, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386755775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 2003010856 (Missouri) | Primary |
| Entity Name | Southern Urgent Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205136470 PECOS PAC ID: 4082802509 Enrollment ID: O20101228001013 |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen Larson, MD Po Box 4853, Oak Brook, IL 60522-4853 Ph: (314) 344-6000 | Stephen Larson, MD 12303 De Paul Dr, Bridgeton, MO 63044-2512 Ph: (314) 344-6000 |
Norman J Ehlinger Jr., DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3436a Mckelvey Rd, Bridgeton, MO 63044 Phone: 314-739-5518 Fax: 314-739-1223 | |
Laura Marie Viero-dothage, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 12303 Depaul Dr, Depaul Health Center, Bridgeton, MO 63044 Phone: 314-344-6000 Fax: 630-734-1560 | |
Dr. Anil Kumar Srivastava, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 12266 De Paul Dr Ste 305, Bridgeton, MO 63044 Phone: 314-770-0991 | |
Timothy F Reed, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 12303 Depaul Drive, Bridgeton, MO 63044 Phone: 314-344-6000 | |
Gilbert N Jones, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 12303 Depaul Drive, Bridgeton, MO 63044 Phone: 314-344-6000 | |
Angela Lloyd, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 12303 Depaul Drive, Bridgeton, MO 63044 Phone: 314-344-6000 |