| Frontier Integrated Health Center Inc | |
|
199 Frontier Park Dr O Fallon MO 63366-3963 | |
| (636) 379-5934 | |
| (636) 410-3323 |
| Full Name | Frontier Integrated Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 199 Frontier Park Dr, O Fallon, Missouri |
| Authorized Official Name and Position | Raymond James Ottomeyer (OWNER) |
| Authorized Official Contact | 6363795934 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Frontier Integrated Health Center Inc 199 Frontier Park Dr O Fallon MO 63366-3963 Ph: (636) 379-5934 | Frontier Integrated Health Center Inc 199 Frontier Park Dr O Fallon MO 63366-3963 Ph: (636) 379-5934 |
| NPI Number | 1114120649 |
|---|---|
| Provider Enumeration Date | 06/11/2007 |
| Last Update Date | 02/24/2022 |
| Medicare PECOS PAC ID | 6204814304 |
|---|---|
| Medicare Enrollment ID | O20040713001148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114120649 | NPI | - | NPPES |
| 160876 | Other | MO | BLUECROSS |
| 2576722 | Other | MO | UNITED HEALTHCARE |
| 375245 | Other | MO | HEALTHLINK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | 112431 (Missouri) | Primary |
| Provider Name | David J Hadden |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1184796732 PECOS PAC ID: 3476636721 Enrollment ID: I20080211000438 |
| Provider Name | Raymond Ottomeyer |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1134235799 PECOS PAC ID: 5698782100 Enrollment ID: I20100819000064 |
| Provider Name | Andrew S Rackovan |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1003239989 PECOS PAC ID: 9931330271 Enrollment ID: I20140328002225 |
Kevin L. Threlkeld, M.d., Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 204 N Main St, O Fallon, MO 63366 Phone: 636-240-3420 | |
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O'fallon Pain Relief Associates Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2682 Babble Creek Ln, O Fallon, MO 63368 Phone: 636-978-3000 Fax: 636-978-1821 | |
Surgical Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Church St, O Fallon, MO 63366 Phone: 636-240-1100 Fax: 636-240-1104 | |
Chiro Co Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2917 Highway K Ste F, O Fallon, MO 63368 Phone: 314-239-2427 | |
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