Dr Keane Emile Mccullum, MD - Medicare Obstetrics & Gynecology in Fort Leonard Wood, MO

Dr Keane Emile Mccullum, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Fort Leonard Wood, Missouri. His current practice location is 4430 Missouri Ave, Fort Leonard Wood, Missouri. You can reach out to his office (for appointments etc.) via phone at (573) 596-1770.

Dr Keane Emile Mccullum is licensed to practice in Hawaii (license number 20964) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1841793510.

Contact Information

Dr Keane Emile Mccullum, MD
4430 Missouri Ave,
Fort Leonard Wood, MO 65473-9098
(573) 596-1770
Not Available



Physician's Profile

Full NameDr Keane Emile Mccullum
GenderMale
SpecialityObstetrics & Gynecology
Location4430 Missouri Ave, Fort Leonard Wood, Missouri
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1841793510
  • Provider Enumeration Date: 03/08/2018
  • Last Update Date: 08/25/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2466801709
  • Enrollment ID: I20231212000768

Medical Identifiers

Medical identifiers for Dr Keane Emile Mccullum such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1841793510NPI-NPPES
NAD000OtherMEDICARE UPIN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207V00000XObstetrics & Gynecology 20964 (Hawaii)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Keane Emile Mccullum allows following entities to bill medicare on his behalf.
Entity NameAspirus Keweenaw
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205998713
PECOS PAC ID: 8123912011
Enrollment ID: O20040211000763

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Keane Emile Mccullum is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Keane Emile Mccullum, MD
4430 Missouri Ave,
Fort Leonard Wood, MO 65473-9098

Ph: () -
Dr Keane Emile Mccullum, MD
4430 Missouri Ave,
Fort Leonard Wood, MO 65473-9098

Ph: (573) 596-1770

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Obstetrics & Gynecology Doctors in Fort Leonard Wood, MO

Dr. Leah Swanzy Scarlotta, MD
Obstetrics & Gynecology
Medicare: Medicare Enrolled
Practice Location: 4430 Missouri Ave, Fort Leonard Wood, MO 65473
Phone: 713-594-6936    

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