George P Samuel, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R5B21 Issued in MO

Practice address

1 Hospital Dr
Doniphan, MO 63935-1274

Phone

(573) 996-7148

Fax

(573) 996-4041

NPI assigned

Apr 18, 2006

Last updated

Feb 28, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Health Care Management Services, LLC

  dba Advanced Foot & Ankle Clinic

  • Podiatric Clinic/Center
  • Poplar Bluff, MO
  • NPI 1306802632
  NPD (past)
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1316902901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 989",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639020989",
            "telephone_number": "573-778-0020",
            "fax_number": "573-776-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "DONIPHAN",
            "state": "MO",
            "postal_code": "639351274",
            "telephone_number": "573-996-7148",
            "fax_number": "573-996-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "GEORGE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R5B21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "188260",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201563616",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rocky River Resort, Inc. (Preferred Home Care)
• Lauren Elizabeth Rowland, DDS
• Melissa Rowland, FNP
• Logan Rush, D.C.
• Keshia J Russell, MCD, CCC-SLP
• Liz Olinda Sanchez
• Dena Seratt
• Natasha Lynn Shepherd
• Shopko Stores Operating Co LLC (Shopko Pharmacy 706)
• Shopko Stores Operating Co LLC (Shopko Pharmacy 706)

• Internal Medicine Physician in Doniphan, MO
• Providers in Doniphan, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.