Eric E. Luebbert, D.O., P.C.
Organization Active NPI Diagnostic Radiology Physician · Marshfield, MO
NPI 1003286931 · NPPES record last updated Oct 5, 2015
Key facts
- NPI
- 1003286931
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 3363 (IA)
- Legal business name
- ERIC E. LUEBBERT, D.O., P.C.
- Practice address
- 133 Hillsboro St
Marshfield, MO 65706-1122 - Phone
- (417) 468-7000
- NPI assigned
- Oct 5, 2015
- Organization subpart
- No
Authorized official
- Name
- Dr. Eric Eugene Luebbert, D.O.
- Title
- D.O.
- Phone
- (417) 468-7000
Practitioners 1
-
Eric E Luebbert, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA, MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151109000162 | IA | Part B Supplier - Clinic/Group Practice | 1658681697 |
Receives reassigned benefits from 1 practitioner Practice locations: Clive, IA; Des Moines, IA; Ida Grove, IA; West Des Moines, IA |
| O20160328000506 | MO | Part B Supplier - Clinic/Group Practice | 1658681697 |
Receives reassigned benefits from 1 practitioner Practice locations: Marshfield, MO |
National Provider Directory
Locations
12368 Stratford Dr
Ste 300
Des Moines, IA 50325
Phone (515) 228-9810
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | 3363 | IA | Yes |
Addresses
Primary practice location
133 Hillsboro St
Marshfield, MO 65706-1122
Mailing address
133 Hillsboro St
Marshfield, MO 65706-1122
Phone (417) 468-7000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285694497 | Other | NPI |
Other providers in Marshfield, MO
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- Katherine Miriam Evans
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All providers in Marshfield, MO · Diagnostic Radiology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.