MR. REZA JALAL (NPI# 1578528618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578528618 |
| Entity Type | Individual |
| Full Name | MR. REZA JALAL |
| Credential | MD |
| Practice Address |
1300 N One Mile Rd Suite 1 Dexter MO 63841-1042 |
| Mailing Address |
Po Box 368 Dexter MO 63841 |
| Practice Telephone | 5736247788 |
| Mailing Telephone | 5736243165 |
| Mailing Fax Number | 5736243157 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2013-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 112378 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 208949008 | 05 | |
| MO | RAILROAD MEDICARE | P00192519 | 01 |
| MO | HEALTHLINK | 341420 | 01 |
| MO | BCBS | 111316 | 01 |
| Street Address |
1300 N ONE MILE RD SUITE 1 |
| City | DEXTER |
| State | MO |
| Zip Code | 63841-1042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801891015 | Southeast Health Center of Stoddard County, LLC | Home Health | 1300 N One Mile Rd, Suite 7, Dexter, MO 63841-1042 | 2005-06-15 |
| 1083848923 | Stoddard County Family Care LLC | Clinic/Center | 1300 N One Mile Rd, Dexter, MO 63841-1042 | 2009-05-06 |
| 1528273117 | Stacey Grays | Nurse Practitioner | 1300 N One Mile Rd, Dexter, MO 63841-1042 | 2007-05-14 |
| 1649399031 | Jean Brown | Nurse Practitioner | 1300 N One Mile Rd, Suite 1, Dexter, MO 63841-1042 | 2007-03-28 |
| 1629111729 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 1300 N One Mile Rd, Dexter, MO 63841-1042 | 2007-02-15 |
| 1073656153 | Dexter Hospital LLC | Pediatrics | 1300 N One Mile Rd, Suite 2, Dexter, MO 63841-1042 | 2007-02-15 |
| 1629132790 | Dexter Hospital LLC | Surgery | 1300 N One Mile Rd, Suite 7, Dexter, MO 63841 | 2006-12-21 |
| 1780745414 | Dexter Hospital LLC | Surgery | 1300 N One Mile Rd, Suite 5, Dexter, MO 63841 | 2006-12-13 |
| 1477613370 | Dexter Hosptial LLC | Internal Medicine | 1300 N One Mile Rd, Suite 1, Dexter, MO 63841 | 2006-12-11 |
| 1710047618 | Southeast Health Center of Stoddard County, LLC | Clinic/Center | 1300 N One Mile Rd, Suite 2, Dexter, MO 63841-1042 | 2006-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558941 | Christa Renee Mcbroom | Pharmacist | 2025 Business Hwy 60w, Dexter, MO 63841 | 2020-11-02 |
| 1306230107 | David Mulcahy | Pharmacist | 904 West Business Hwy 60, Dexter, MO 63841 | 2015-03-19 |
| 1285038935 | Clearwater In-home Care, Inc. | Technician | 1525 Business Highway 60, Suite C, Dexter, MO 63841 | 2014-10-09 |
| 1720404064 | William Simmons | Pharmacist | 904 W Business Highway 60, Dexter, MO 63841 | 2014-03-11 |
| 1134498736 | Susan Caroline Jones | Physical Therapist | 913 West Business Hwy 60, Dexter, MO 63841 | 2011-12-28 |
| 1427350594 | Dexter Hospital LLC | Family Medicine | 2025 W Bus Hwy 60, Dexter, MO 63841 | 2010-11-23 |
| 1992028112 | Hilda Fuwell's Residential Care LLC | Clinic/Center | 900 South One Mile Road, Dexter, MO 63841 | 2010-03-02 |
| 1508197047 | Super D Drugs Acquisition Co | Durable Medical Equipment & Medical Supplies | 907 West Business Hwy. 60, Dexter, MO 63841 | 2010-01-22 |
| 1215262183 | Ozark Wellness & Athletic Club | Physical Therapist | 1521 W Bus. Hwy. 60, Dexter, MO 63841 | 2009-10-12 |
| 1225268618 | Practice Tee, LLC | Family Medicine | 1523 W Business Hwy 60, Dexter, MO 63841 | 2009-07-20 |
| Find all providers in zip 63841 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942847363 | Arthur Thomas Waytes | Internal Medicine | 2490 Scio Rd, Dexter, MI 48130-9716 | 2019-12-04 |
| 1124198551 | Chelsea Professional Services | Internal Medicine | 8031 Main Street, Suite 203, Dexter, MI 48130 | 2006-11-09 |
| 1811931249 | Robert J. Lodato | Internal Medicine | 41 High St, Dexter, ME 04930-1311 | 2006-06-15 |
| 1750367033 | Bradford Bittner Wylie | Internal Medicine | 7093 Dexter Ann Arbor Rd, Dexter, MI 48130-8568 | 2005-12-19 |
| 1730717943 | Iha Health Services Corporation | Internal Medicine | 7093 Dexter Ann Arbor Rd, Dexter, MI 48130-8568 | 2020-04-01 |
| 1700139169 | La Joya, LLC | Internal Medicine | 75 Yakima Rd, Dexter, NM 88230-9757 | 2012-10-23 |
| 1174645931 | Mrh Corp. | Internal Medicine | 41 High St, Dexter, ME 04930-1311 | 2007-04-04 |
| 1477613370 | Dexter Hosptial LLC | Internal Medicine | 1300 N One Mile Rd, Suite 1, Dexter, MO 63841 | 2006-12-11 |
| 1245288992 | Rhonda S. Todd | Internal Medicine | 7093 Dexter Ann Arbor Rd, Dexter, MI 48130-8568 | 2006-05-05 |
| 1447208533 | Suzanne H Thomashow | Internal Medicine | 7444 Dexter Ann Arbor Rd Ste A, Dexter, MI 48130-1468 | 2006-05-04 |
| Find all providers in DEXTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.