| Neurologic Associates Of Cape Girardeau, Inc | |
|
3250 Gordonville Rd Ste 206 Cape Girardeau MO 63703-5095 | |
| (573) 651-3188 | |
| (573) 651-3048 |
| Full Name | Neurologic Associates Of Cape Girardeau, Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3250 Gordonville Rd Ste 206, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Robert E Gardner (PRESIDENT) |
| Authorized Official Contact | 5736513188 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurologic Associates Of Cape Girardeau, Inc 3250 Gordonville Rd Ste 206 Cape Girardeau MO 63703-5095 Ph: (573) 651-3188 | Neurologic Associates Of Cape Girardeau, Inc 3250 Gordonville Rd Ste 206 Cape Girardeau MO 63703-5095 Ph: (573) 651-3188 |
| NPI Number | 1053435719 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 08/23/2011 |
| Medicare PECOS PAC ID | 7416028758 |
|---|---|
| Medicare Enrollment ID | O20080613000586 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053435719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Robert Earl Gardner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649365917 PECOS PAC ID: 0042318297 Enrollment ID: I20070612000179 |
| Provider Name | Robert E Gardner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346251436 PECOS PAC ID: 0143391482 Enrollment ID: I20100817001250 |
| Provider Name | David Ys Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861505703 PECOS PAC ID: 2961573209 Enrollment ID: I20100826000256 |
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