| Suzanne M Pautler, MD | |
|
1445 Christy Dr, Jefferson City, MO 65101-2853 | |
| (573) 636-3483 | |
| (573) 636-5315 |
| Full Name | Suzanne M Pautler |
|---|---|
| Gender | Female |
| Speciality | Anesthesiology |
| Location | 1445 Christy Dr, Jefferson City, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083609697 | NPI | - | NPPES |
| P00387102 | Other | MO | RR MEDICARE |
| 203681523 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | R1K42 (Missouri) | Primary |
| Entity Name | Metro-west Anesthesia Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245427335 PECOS PAC ID: 2163329921 Enrollment ID: O20031219000779 |
| Mailing Address | Practice Location Address |
|---|---|
| Suzanne M Pautler, MD 525 Couch Ave, Kirkwood, MO 63122-5536 Ph: (573) 636-3483 | Suzanne M Pautler, MD 1445 Christy Dr, Jefferson City, MO 65101-2853 Ph: (573) 636-3483 |
Scott W. Tanner, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1445 Christy Dr, Jefferson City, MO 65101 Phone: 573-636-3483 Fax: 573-636-5315 | |
Mark R. Frederick, DO Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1445 Christy Dr, Jefferson City, MO 65101 Phone: 573-636-3483 Fax: 573-636-5315 | |
Thomas E Hetherington, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1125 Madison St, Jefferson City, MO 65101 Phone: 573-632-5000 | |
Dr. Deana Michelle Berrey, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1241 W Stadium Blvd, Jefferson City, MO 65109 Phone: 573-556-5771 | |
Dr. Nicolette Christine Wise, DO Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1125 Madison St, Jefferson City, MO 65101 Phone: 316-268-5000 | |
Adelia L. Doerhoff, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1445 Christy Dr, Jefferson City, MO 65101 Phone: 573-636-3483 Fax: 573-636-5315 |