Hannibal Clinic Operations, L.l.c | |
100 Medical Dr Hannibal MO 63401-6877 | |
(573) 221-5250 | |
(573) 231-3706 |
Full Name | Hannibal Clinic Operations, L.l.c |
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Speciality | General Practice |
Location | 100 Medical Dr, Hannibal, Missouri |
Authorized Official Name and Position | Michael J Bukstein (PHYSICIAN EXEC. DIRECTOR) |
Authorized Official Contact | 5732313172 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Hannibal Clinic Operations, L.l.c 100 Medical Dr Hannibal MO 63401-6877 Ph: (573) 221-5250 | Hannibal Clinic Operations, L.l.c 100 Medical Dr Hannibal MO 63401-6877 Ph: (573) 221-5250 |
NPI Number | 1427037225 |
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Provider Enumeration Date | 01/11/2006 |
Last Update Date | 04/18/2022 |
Medicare PECOS PAC ID | 9931094182 |
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Medicare Enrollment ID | O20170714000477 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427037225 | NPI | - | NPPES |
000013772 | Other | MO | PTAN |
500221007 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Prashanth Podaralla |
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Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1730226952 PECOS PAC ID: 5496886699 Enrollment ID: I20150820012020 |
Provider Name | Aphrodite Henderson |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1861471450 PECOS PAC ID: 0547302366 Enrollment ID: I20170717000414 |
Provider Name | Melissa Matrisch |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1811215064 PECOS PAC ID: 3476861568 Enrollment ID: I20170717002826 |
Provider Name | Patricia Hirner |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1114906716 PECOS PAC ID: 6305986969 Enrollment ID: I20170802003094 |
Provider Name | Bhagirath H Katbamna |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1447239041 PECOS PAC ID: 5395889679 Enrollment ID: I20180123001178 |
Provider Name | Michael J Bukstein |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1912986688 PECOS PAC ID: 7012946247 Enrollment ID: I20180514001943 |
Hannibal Regional Healthcare System Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6000 Hospital Drive, Hannibal, MO 63401 Phone: 573-248-1300 Fax: 573-248-5448 | |
Hannibal Regional Healthcare System, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6500 Hospital Dr, Hannibal, MO 63401 Phone: 573-629-3440 Fax: 573-629-3442 | |
Hannibal Regional Healthcare System,inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3650 Stardust Dr, Hannibal, MO 63401 Phone: 573-231-0660 Fax: 573-231-0687 | |
Preferred Family Health Care, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 653 Clinic Rd, Hannibal, MO 63401 Phone: 573-603-1460 | |
Hannibal Regional Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3650 Stardust Dr, Hannibal, MO 63401 Phone: 573-231-0660 Fax: 573-231-0687 | |
Marion County Health Dept. & Home Health Agency Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3105 Rt. W, Hannibal, MO 63401 Phone: 573-221-1166 Fax: 573-221-1214 |