| Northeast Regional Medical Group | |
|
1607 S Baltimore St Kirksville MO 63501-4536 | |
| (660) 627-3363 | |
| (660) 627-3367 |
| Full Name | Northeast Regional Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1607 S Baltimore St, Kirksville, Missouri |
| Authorized Official Name and Position | Brian Peoples (VICE-PRESIDENT) |
| Authorized Official Contact | 6154657585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Regional Medical Group Po Box 689022 Franklin TN 37068-9022 Ph: (615) 465-7000 | Northeast Regional Medical Group 1607 S Baltimore St Kirksville MO 63501-4536 Ph: (660) 627-3363 |
| NPI Number | 1336491448 |
|---|---|
| Provider Enumeration Date | 10/12/2012 |
| Last Update Date | 12/04/2012 |
| Medicare PECOS PAC ID | 3274517347 |
|---|---|
| Medicare Enrollment ID | O20130312000204 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336491448 | NPI | - | NPPES |
| Provider Name | Tysen J Petre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871642470 PECOS PAC ID: 7719080845 Enrollment ID: I20070312000033 |
| Provider Name | John M Deleeuw |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770590846 PECOS PAC ID: 6507969599 Enrollment ID: I20070313000007 |
| Provider Name | David Vincent Spencer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154820157 PECOS PAC ID: 1052673472 Enrollment ID: I20180724002212 |
| Provider Name | Valena N Fiscus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386087757 PECOS PAC ID: 4486943636 Enrollment ID: I20201008000742 |
| Provider Name | Nancy Lynn Rourke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811615529 PECOS PAC ID: 0143696104 Enrollment ID: I20221014002756 |
Hannibal Regional Healthcare System, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1611 S Baltimore St, Kirksville, MO 63501 Phone: 660-665-7575 Fax: 660-665-7576 | |
James D. Smith, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1108 E Patterson St, Suite 10, Kirksville, MO 63501 Phone: 660-665-4265 | |
Physician Services Of Missouri Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1611 S Baltimore St, Kirksville, MO 63501 Phone: 859-514-5547 Fax: 859-422-4907 | |
Sparks Clinic P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1410 Crown Dr, Kirksville, MO 63501 Phone: 660-665-1400 Fax: 660-665-2081 | |
Adair County Health Dept Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1001 S. Jamison St, Kirksville, MO 63501 Phone: 660-665-8491 Fax: 660-627-2913 | |
Kirksville Academic Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 W Jefferson St, Kirksville, MO 63501 Phone: 660-626-2235 Fax: 660-626-2090 |