| 417 Sports Medicine And Orthopedics Llc | |
|
3328 S National Ave Springfield MO 65807-7305 | |
| (417) 771-3147 | |
| Not Available |
| Full Name | 417 Sports Medicine And Orthopedics Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3328 S National Ave, Springfield, Missouri |
| Authorized Official Name and Position | Eric Gifford (PHYSICIAN) |
| Authorized Official Contact | 8178255096 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 417 Sports Medicine And Orthopedics Llc 2100 E Norshire St Springfield MO 65804-7829 Ph: (817) 825-5096 | 417 Sports Medicine And Orthopedics Llc 3328 S National Ave Springfield MO 65807-7305 Ph: (417) 771-3147 |
| NPI Number | 1871105312 |
|---|---|
| Provider Enumeration Date | 08/17/2020 |
| Last Update Date | 05/16/2024 |
| Medicare PECOS PAC ID | 8628495678 |
|---|---|
| Medicare Enrollment ID | O20200904001390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871105312 | NPI | - | NPPES |
| 7860260001 | Other | NATIONAL SUPPLIER CLEARING HOUSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Eric M Gifford |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1144532490 PECOS PAC ID: 5496991077 Enrollment ID: I20140604002364 |
| Provider Name | Nathan Isaac Graff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609195569 PECOS PAC ID: 8426441890 Enrollment ID: I20220207001896 |
James M. Carmichael, Dc Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3108 S Fremont Ave, Springfield, MO 65804 Phone: 417-886-4910 Fax: 417-886-4910 | |
Regional Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3525 S National Ave, #307, Springfield, MO 65807 Phone: 417-269-9220 Fax: 417-269-9229 | |
Lester E. Cox Medical Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3800 S National Ave, #600, Springfield, MO 65807 Phone: 417-269-1499 Fax: 417-269-1459 | |
Regional Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1423 N Jefferson Ave, #k-100, Springfield, MO 65802 Phone: 417-269-3915 Fax: 417-269-3913 | |
Mercy Clinic Hospitalists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2600 Fax: 417-820-2100 | |
Lester E Cox Medical Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1429 W Sunshine St, Springfield, MO 65807 Phone: 417-269-2240 Fax: 417-269-2245 | |
Advocates For A Healthy Community, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1720 W Grand St Ste B, Springfield, MO 65802 Phone: 417-831-0150 Fax: 417-831-0155 |