| Shaffer Rainey Dermatology | |
|
110 Business Park Dr Ste C Branson MO 65616-7426 | |
| (417) 239-0125 | |
| Not Available |
| Full Name | Shaffer Rainey Dermatology |
|---|---|
| Speciality | Clinic/Center |
| Location | 110 Business Park Dr Ste C, Branson, Missouri |
| Authorized Official Name and Position | Christy Shaffer Rainey (OWNER) |
| Authorized Official Contact | 4172390125 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaffer Rainey Dermatology 110 Business Park Drive Suite C Branson MO 65616-8156 Ph: (417) 239-0125 | Shaffer Rainey Dermatology 110 Business Park Dr Ste C Branson MO 65616-7426 Ph: (417) 239-0125 |
| NPI Number | 1174793533 |
|---|---|
| Provider Enumeration Date | 03/01/2008 |
| Last Update Date | 07/06/2009 |
| Medicare PECOS PAC ID | 9931285798 |
|---|---|
| Medicare Enrollment ID | O20080320000037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174793533 | NPI | - | NPPES |
| 204056105 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2007035572 (Missouri) | Primary |
| Provider Name | Christy Rainey |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1790999100 PECOS PAC ID: 9133201056 Enrollment ID: I20080320000033 |
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