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Showing codes 1194720870 — 1205831013
1194720870 -
DR.
DR.
TIMOTHY
GUY
GRUBE
D.O.
Other Name
:
Mailing Address
:
219 S BALLIET ST
FRACKVILLE
PA
17931-2105
Phone
: 570-874-3404;
Fax
: 570-874-1491;
Practice Location Address
:
219 S BALLIET ST
,
, FRACKVILLE
, PA
, 17931-2105
Practice Phone
: 570-874-3404;
Practice Fax
: 570-874-1491
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1003811787 -
DAVID
S
SPRINGER
M.D.
Other Name
:
Mailing Address
:
1 ERIE CT
STE 6140
OAK PARK
IL
60302-2510
Phone
: 708-848-2400;
Fax
: 708-445-8269;
Practice Location Address
:
1 ERIE CT
, STE 6140
, OAK PARK
, IL
, 60302-2510
Practice Phone
: 708-848-2400;
Practice Fax
: 708-445-8269
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1912902693 -
DR.
DR.
DAVID
MICHAEL
MELGARY
O.D.
Other Name
:
Mailing Address
:
3233 BELMONT ST
BELLAIRE
OH
43906-1520
Phone
: 740-676-4717;
Fax
: 740-676-4695;
Practice Location Address
:
3233 BELMONT ST
,
, BELLAIRE
, OH
, 43906-1520
Practice Phone
: 740-676-4717;
Practice Fax
: 740-676-4695
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1265437941 -
MRS.
MRS.
JANE
KATHRYN
CRISPELL
LCSW-R
Other Name
:
Mailing Address
:
903 HANSHAW RD
ITHACA
NY
14850-1530
Phone
: 607-280-5850;
Fax
: ;
Practice Location Address
:
903 HANSHAW RD
,
, ITHACA
, NY
, 14850-1530
Practice Phone
: 607-280-5850;
Practice Fax
:
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1174528855 -
RANAE
MARIE
SPORE
PHARMACY TEC.
Other Name
:
Mailing Address
:
PO BOX 154
STARBUCK
MN
56381-0154
Phone
: 320-239-2246;
Fax
: 320-239-2296;
Practice Location Address
:
406 8 1/2 STREET
,
, STARBUCK
, MN
, 56381-0154
Practice Phone
: 320-239-2246;
Practice Fax
: 320-239-2296
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1083619761 -
FAIRHAVEN CORPORATION
Other Name
:
Mailing Address
:
435 W STARIN RD
WHITEWATER
WI
53190-1133
Phone
: 262-473-3445;
Fax
: 262-473-5468;
Practice Location Address
:
435 W STARIN RD
,
, WHITEWATER
, WI
, 53190-1133
Practice Phone
: 262-473-3445;
Practice Fax
: 262-473-5468
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1891790572 -
DR.
DR.
SUSAN
ANGELISANTI
M.D.
Other Name
:
Mailing Address
:
PO BOX 783311
PHILADELPHIA
PA
19178-3311
Phone
: ;
Fax
: ;
Practice Location Address
:
333 NORMAL AVE
,
, KUTZTOWN
, PA
, 19530-1640
Practice Phone
: 610-683-5522;
Practice Fax
:
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1700881489 -
DR.
DR.
DEBORAH
KAY
LEHMANN
M.D.
Other Name
:
Mailing Address
:
702 N 13TH ST
ARTESIA
NM
88210-1199
Phone
: 575-748-3333;
Fax
: ;
Practice Location Address
:
702 N 13TH ST
,
, ARTESIA
, NM
, 88210-1199
Practice Phone
: 575-748-3333;
Practice Fax
:
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1619972395 -
JONATHAN
COVAULT
MD
Other Name
:
Mailing Address
:
263 FARMINGTON AVE
PROVIDER ENROLLMENT
FARMINGTON
CT
06030-2212
Phone
: 860-679-7503;
Fax
: 860-679-1610;
Practice Location Address
:
263 FARMINGTON AVE
,
, FARMINGTON
, CT
, 06030-6410
Practice Phone
: 860-679-6703;
Practice Fax
: 860-679-1296
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1528063203 -
DR.
DR.
RICHARD
DAVIS
HART
DO
Other Name
:
Mailing Address
:
15 BRENTWOOD TRACE
CLYDE
NC
28721-8021
Phone
: 828-452-9700;
Fax
: 828-452-3701;
Practice Location Address
:
423 S SOUTH ST
, STE.101
, MOUNT AIRY
, NC
, 27030-4576
Practice Phone
: 336-786-5144;
Practice Fax
: 336-786-5146
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1437154119 -
MARCO
ANTONIO
CASTRO
D.C.
Other Name
:
Mailing Address
:
9400 CARNEGIE AVE
UNIT B
EL PASO
TX
79925-1422
Phone
: 915-500-5741;
Fax
: 915-581-6409;
Practice Location Address
:
9400 CARNEGIE AVE
, UNIT B
, EL PASO
, TX
, 79925-1422
Practice Phone
: 915-500-5741;
Practice Fax
: 915-581-6409
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1972508653 -
CALVIN
G.
WARREN
JR.
M.D.
Other Name
:
Mailing Address
:
703 NEWMAN ROAD
NEW BERN
NC
28562
Phone
: 252-633-2900;
Fax
: 252-633-9609;
Practice Location Address
:
703 NEWMAN ROAD
,
, NEW BERN
, NC
, 28562
Practice Phone
: 252-633-2900;
Practice Fax
: 252-633-9609
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1881699569 -
DR.
DR.
REINALDO
VAZQUEZ
M. D.
Other Name
:
Mailing Address
:
PO BOX 250432
AGUADILLA
PR
00604-0432
Phone
: 787-890-0085;
Fax
: 787-890-0085;
Practice Location Address
:
CARR. 110 KM. 8.8
,
, AGUADILLA
, PR
, 00603-0000
Practice Phone
: 787-890-0085;
Practice Fax
: 787-890-0085
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1699770370 -
TAM
HUU
LE
M.D.
Other Name
:
Mailing Address
:
18111 BROOKHURST ST
2600
FOUNTAIN VALLEY
CA
92708-6728
Phone
: 714-861-4560;
Fax
: 714-861-4566;
Practice Location Address
:
18225 BROOKHURST ST STE 1
,
, FOUNTAIN VALLEY
, CA
, 92708-6719
Practice Phone
: 714-861-4560;
Practice Fax
: 714-861-4566
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1508861287 -
THEODORE
D
BAKER
MD
Other Name
:
Mailing Address
:
2000A SOUTHBRIDGE PKWY
STE 300
BIRMINGHAM
AL
35209-7718
Phone
: 205-871-4274;
Fax
: 205-871-4301;
Practice Location Address
:
50 MEDICAL PARK DR E
,
, BIRMINGHAM
, AL
, 35235-3401
Practice Phone
: 205-838-3435;
Practice Fax
:
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1417952193 -
STEVEN
M
WILLIAMS
M.D.
Other Name
:
Mailing Address
:
4350 MIDDLE SETTLEMENT RD
NEW HARTFORD
NY
13413-5345
Phone
: 315-732-0995;
Fax
: 315-732-0689;
Practice Location Address
:
4350 MIDDLE SETTLEMENT RD
,
, NEW HARTFORD
, NY
, 13413-5345
Practice Phone
: 315-732-0995;
Practice Fax
: 315-732-0689
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1326043001 -
DR.
DR.
STEPHEN
DAVID
DOBBS
D.M.D.
Other Name
:
Mailing Address
:
417 MAIN ST
TRUSSVILLE
AL
35173-1418
Phone
: 205-655-4300;
Fax
: ;
Practice Location Address
:
417 MAIN ST
,
, TRUSSVILLE
, AL
, 35173-1418
Practice Phone
: 205-655-4300;
Practice Fax
:
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1235134917 -
DR.
DR.
WINSTON
LOUIS
ALEXIS
M.D.
Other Name
:
Mailing Address
:
150 NW 70TH AVE STE 7
PLANTATION
FL
33317-2911
Phone
: 954-452-4377;
Fax
: 954-452-1022;
Practice Location Address
:
5975 W. SUNRISE BLVD.
, SUITE 105
, SUNRISE
, FL
, 33313
Practice Phone
: 954-791-4311;
Practice Fax
: 954-791-2729
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1144225822 -
DR.
DR.
ROBERT
LORIN
CANTRELL
M.D
Other Name
:
Mailing Address
:
PO BOX 660599
DALLAS
TX
75266-0599
Phone
: ;
Fax
: ;
Practice Location Address
:
9202 ELAM RD
, SOUTHEAST DALLAS HEALTH CENTER
, DALLAS
, TX
, 75217-4151
Practice Phone
: 214-266-1600;
Practice Fax
: 214-266-1790
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1053316737 -
MR.
MR.
PAUL
DONOVAN
MCAREAVEY
RPT
Other Name
:
Mailing Address
:
706 S 1ST ST
BLACKWELL
OK
74631-3825
Phone
: 580-363-1111;
Fax
: 580-363-1116;
Practice Location Address
:
2005 N 14TH ST
, STE 111
, PONCA CITY
, OK
, 74601-1952
Practice Phone
: 580-765-0101;
Practice Fax
: 580-765-3434
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1962407643 -
MYUNG
YONG
CHANG
M.D.
Other Name
:
Mailing Address
:
3300 BUCKEYE RD
STE 178
ATLANTA
GA
30341-4232
Phone
: 770-458-6103;
Fax
: 770-234-0437;
Practice Location Address
:
3300 BUCKEYE RD
, STE 178
, ATLANTA
, GA
, 30341-4232
Practice Phone
: 770-458-6103;
Practice Fax
: 770-234-0437
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1871598557 -
DR.
DR.
CHRISTOPHER
J.
VANDELUNE
D.O.
Other Name
:
Mailing Address
:
115 E MAPLE ST
CHEROKEE
IA
51012-1814
Phone
: 712-225-9003;
Fax
: 712-225-9004;
Practice Location Address
:
115 E MAPLE ST
,
, CHEROKEE
, IA
, 51012-1814
Practice Phone
: 712-225-9003;
Practice Fax
: 712-225-9004
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1780689463 -
TIDALHEALTH PENINSULA REGIONAL, INC.
Other Name
:
Mailing Address
:
100 E CARROLL ST
SALISBURY
MD
21801-5422
Phone
: 410-546-6400;
Fax
: 410-543-7020;
Practice Location Address
:
100 E CARROLL ST
,
, SALISBURY
, MD
, 21801-5422
Practice Phone
: 410-546-6400;
Practice Fax
: 410-543-7020
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1699770388 -
RAJIV
Y.
CHANDAWARKAR
MD
Other Name
:
Mailing Address
:
700 ACKERMAN RD STE 2120
COLUMBUS
OH
43202-1559
Phone
: 614-293-8566;
Fax
: 614-293-3381;
Practice Location Address
:
181 TAYLOR AVE FL 1
,
, COLUMBUS
, OH
, 43203
Practice Phone
: 614-293-8566;
Practice Fax
: 614-293-3381
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1508861295 -
AMANDA
T
DAVIS
M.D.
Other Name
:
Mailing Address
:
3300 BUCKEYE RD
STE 178
ATLANTA
GA
30341-4232
Phone
: 770-458-6103;
Fax
: 770-234-0437;
Practice Location Address
:
3300 BUCKEYE RD
, STE 178
, ATLANTA
, GA
, 30341-4232
Practice Phone
: 770-458-6103;
Practice Fax
: 770-234-0437
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1417952102 -
DR.
DR.
MARTIN
AVILES
M.D.
Other Name
:
Mailing Address
:
627 BIENVILLE CIR
NATCHITOCHES
LA
71457-5744
Phone
: 318-352-9595;
Fax
: 318-352-9818;
Practice Location Address
:
627 BIENVILLE CIR
,
, NATCHITOCHES
, LA
, 71457-5744
Practice Phone
: 318-352-9595;
Practice Fax
: 318-352-9818
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1306841093 -
DR.
DR.
RICHARD
J
BROWN
D.P.M.
Other Name
:
Mailing Address
:
37 W 7TH ST
STE 409
CINCINNATI
OH
45202-2414
Phone
: 513-621-4370;
Fax
: 513-621-4375;
Practice Location Address
:
37 W 7TH ST
, STE 409
, CINCINNATI
, OH
, 45202-2414
Practice Phone
: 513-621-4370;
Practice Fax
: 513-621-4375
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1215932900 -
DR.
DR.
SHI-TZE
LU
M.D.
Other Name
:
Mailing Address
:
4543 POST OAK PLACE DR
SUITE 105
HOUSTON
TX
77027-3160
Phone
: 713-797-1087;
Fax
: 713-797-9814;
Practice Location Address
:
4543 POST OAK PLACE DR
, SUITE 105
, HOUSTON
, TX
, 77027-3160
Practice Phone
: 713-797-1087;
Practice Fax
: 713-797-9814
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1124023817 -
DR.
DR.
TOMINA
BETH
VANCE
D.D.S.
Other Name
:
Mailing Address
:
1124 E 8TH ST
WESLACO
TX
78596-7152
Phone
: 956-968-9762;
Fax
: ;
Practice Location Address
:
1124 E 8TH ST
,
, WESLACO
, TX
, 78596-7152
Practice Phone
: 956-968-9762;
Practice Fax
:
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1033114723 -
DR.
DR.
SCOTT
BRADFORD
PATTERSON
D..D.S., M.S.
Other Name
:
Mailing Address
:
1502 11TH ST
MONROE
WI
53566-1747
Phone
: 608-328-8160;
Fax
: 608-328-8185;
Practice Location Address
:
1502 11TH ST
,
, MONROE
, WI
, 53566-1747
Practice Phone
: 608-328-8160;
Practice Fax
: 608-328-8185
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1942205638 -
DR.
DR.
BALLARD
D
WRIGHT
M.D.
Other Name
:
Mailing Address
:
280 PASADENA DR
LEXINGTON
KY
40503-2925
Phone
: 859-278-1316;
Fax
: 859-276-1574;
Practice Location Address
:
2416 REGENCY RD
, STE 30
, LEXINGTON
, KY
, 40503-2954
Practice Phone
: 859-278-1316;
Practice Fax
: 859-276-1574
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1851396543 -
THOMAS
J.
CLAYTON
D.C.
Other Name
:
Mailing Address
:
PO BOX 406
SENECA
PA
16346-0406
Phone
: 814-677-3881;
Fax
: 814-677-0532;
Practice Location Address
:
3230 STATE ROUTE 257
,
, SENECA
, PA
, 16346-2434
Practice Phone
: 814-677-3881;
Practice Fax
: 814-677-0532
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1760487458 -
DR.
DR.
JADWIGA
M
ALEXIEWICZ
MD
Other Name
:
Mailing Address
:
9610 GRANITE RIDGE DR
STE B
SAN DIEGO
CA
92123-2684
Phone
: 858-810-8000;
Fax
: 858-268-1911;
Practice Location Address
:
7910 FROST ST
, STE 220
, SAN DIEGO
, CA
, 92123-2771
Practice Phone
: 858-637-4700;
Practice Fax
: 858-637-4701
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1003811803 -
DR.
DR.
ERICA
R
WATERS
M.D.
Other Name
:
Mailing Address
:
89 W MARCH LN
STE 1
STOCKTON
CA
95207-5723
Phone
: 209-478-2622;
Fax
: ;
Practice Location Address
:
89 W MARCH LN
, STE 1
, STOCKTON
, CA
, 95207-5723
Practice Phone
: 209-478-2622;
Practice Fax
:
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1912902719 -
DR.
DR.
JONATHAN
SINGER
M.D.
Other Name
:
Mailing Address
:
68 S SERVICE RD
SUITE 350
MELVILLE
NY
11747-2354
Phone
: 516-945-3000;
Fax
: ;
Practice Location Address
:
900 FRANKLIN AVE
,
, VALLEY STREAM
, NY
, 11580-2145
Practice Phone
: 516-256-6000;
Practice Fax
:
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1821093626 -
DR.
DR.
CHARLES
A
GARCIA
MD
Other Name
:
Mailing Address
:
12970 EAST FWY
HOUSTON
TX
77015-5710
Phone
: 281-332-1559;
Fax
: 281-332-3394;
Practice Location Address
:
4704 MONTROSE BLVD
,
, HOUSTON
, TX
, 77006-6122
Practice Phone
: 713-333-0151;
Practice Fax
: 832-485-5080
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1730184532 -
RAMESH
BHALODIA
MD
Other Name
:
Mailing Address
:
PO BOX 2005
EAST SYRACUSE
NY
13057-4505
Phone
: 315-449-0513;
Fax
: 315-445-2936;
Practice Location Address
:
150 BROAD ST
,
, HAMILTON
, NY
, 13346-9575
Practice Phone
: 315-470-7828;
Practice Fax
: 315-470-5811
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1649275447 -
DR.
DR.
JASON
P
ALLEMOND
OD
Other Name
:
Mailing Address
:
2421 CHURCH ST
ZACHARY
LA
70791-2710
Phone
: 225-654-1061;
Fax
: ;
Practice Location Address
:
2421 CHURCH ST
,
, ZACHARY
, LA
, 70791-2710
Practice Phone
: 225-654-1061;
Practice Fax
:
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1558366351 -
MIROSLAWA
SKORUPKA
M.D.
Other Name
:
Mailing Address
:
500 MERRIMACK ST
RIVERWALK
LAWRENCE
MA
01843-1756
Phone
: 978-557-8700;
Fax
: 978-557-8856;
Practice Location Address
:
500 MERRIMACK ST
, RIVERWALK
, LAWRENCE
, MA
, 01843-1756
Practice Phone
: 978-557-8700;
Practice Fax
: 978-557-8856
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1467457267 -
JILL
A
COHEN
M.D.
Other Name
:
Mailing Address
:
7485 E TANQUE VERDE RD
TUCSON
AZ
85715-3477
Phone
: 520-320-7681;
Fax
: 520-320-7684;
Practice Location Address
:
7485 E TANQUE VERDE RD
,
, TUCSON
, AZ
, 85715-3477
Practice Phone
: 520-320-7681;
Practice Fax
: 520-320-7684
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1376548172 -
DR.
DR.
JEFFREY
R
BOXMAN
D.O
Other Name
:
Mailing Address
:
436 CHRIS GAUPP DR
STE 104
GALLOWAY
NJ
08205-4487
Phone
: 609-748-6696;
Fax
: 609-748-6693;
Practice Location Address
:
436 CHRIS GAUPP DR
, STE 104
, GALLOWAY
, NJ
, 08205-4487
Practice Phone
: 609-748-6696;
Practice Fax
: 609-748-6693
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1285639088 -
DR.
DR.
RUSSELL
JOHN
CORNELL
M.D.
Other Name
:
Mailing Address
:
368 LAKEHURST RD
STE 301
TOMS RIVER
NJ
08755-7339
Phone
: 732-240-1048;
Fax
: 732-240-3464;
Practice Location Address
:
368 LAKEHURST RD
, STE 301
, TOMS RIVER
, NJ
, 08755-7339
Practice Phone
: 732-240-1048;
Practice Fax
: 732-240-3464
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1093710899 -
JIANMING
REN
MD
Other Name
:
Mailing Address
:
PO BOX 2005
EAST SYRACUSE
NY
13057-4505
Phone
: 315-449-0513;
Fax
: 315-445-2936;
Practice Location Address
:
736 IRVING AVE
,
, SYRACUSE
, NY
, 13210-1687
Practice Phone
: 315-470-7828;
Practice Fax
: 315-470-5811
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1902801707 -
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:
Mailing Address
:
Phone
: ;
Fax
: ;
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:
,
,
,
,
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: ;
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:
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1811992613 -
DR.
DR.
HENRY
D
DEBIEC
DO
Other Name
:
Mailing Address
:
100 SHENANGO AVE
SHARON
PA
16146-1503
Phone
: 440-293-2444;
Fax
: 440-293-2445;
Practice Location Address
:
5594 STATE ROUTE 7
,
, ANDOVER
, OH
, 44003-9490
Practice Phone
: 440-293-2444;
Practice Fax
: 440-293-2445
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1720083520 -
CLARK
SAUNDERS
M.D.
Other Name
:
Mailing Address
:
3300 OAK LAWN AVE
SUITE 200
DALLAS
TX
75219-4236
Phone
: 214-252-3501;
Fax
: ;
Practice Location Address
:
3300 OAK LAWN AVE
, SUITE 200
, DALLAS
, TX
, 75219-4236
Practice Phone
: 214-252-3501;
Practice Fax
:
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1639174436 -
MARGARET
V
BLANCHARD
MD
Other Name
:
Mailing Address
:
23 MANHATTAN SQ
HAMPTON
VA
23666-5843
Phone
: 757-595-0358;
Fax
: 757-595-6745;
Practice Location Address
:
23 MANHATTAN SQ
,
, HAMPTON
, VA
, 23666-5843
Practice Phone
: 757-595-0358;
Practice Fax
: 757-595-6745
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1548265341 -
TOM
W.
SCHULZ
MD
Other Name
:
Mailing Address
:
4144 N CENTRAL EXPY
#360
DALLAS
TX
75204-3140
Phone
: 214-252-3511;
Fax
: ;
Practice Location Address
:
4144 N CENTRAL EXPY
, #360
, DALLAS
, TX
, 75204-3140
Practice Phone
: 214-252-3511;
Practice Fax
:
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1457356255 -
DR.
DR.
HAROLD
BRUCE
HAMILTON
M.D.
Other Name
:
Mailing Address
:
205 WOODHEW DR
STE 200
WACO
TX
76712-6689
Phone
: 254-776-9775;
Fax
: 254-776-9751;
Practice Location Address
:
205 WOODHEW DR
, STE 200
, WACO
, TX
, 76712-6689
Practice Phone
: 254-776-9775;
Practice Fax
: 254-776-9751
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1366447161 -
DR.
DR.
JAMES
JEROME
SMITH
D.D.S.
Other Name
:
Mailing Address
:
229 BENDEL RD
LAFAYETTE
LA
70503-2903
Phone
: 337-235-1523;
Fax
: 337-235-0699;
Practice Location Address
:
229 BENDEL RD
,
, LAFAYETTE
, LA
, 70503-2903
Practice Phone
: 337-235-1523;
Practice Fax
: 337-235-0699
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1275538076 -
DR.
DR.
EDWARD
C
KIM
MD
Other Name
:
Mailing Address
:
ONE GI CREDENTIALING DEPARTMENT
PO BOX 381468
GERMANTOWN
TN
38183-1468
Phone
: ;
Fax
: ;
Practice Location Address
:
8640 SUDLEY RD STE 201
,
, MANASSAS
, VA
, 20110-4404
Practice Phone
: 703-368-6819;
Practice Fax
: 703-330-2923
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1184629982 -
THOMAS
MEEKS
MD
Other Name
:
Mailing Address
:
5875 BREMO RD
STE 303
RICHMOND
VA
23226-1934
Phone
: 804-484-3700;
Fax
: 804-282-5431;
Practice Location Address
:
5875 BREMO RD
, STE 303
, RICHMOND
, VA
, 23226-1934
Practice Phone
: 804-484-3700;
Practice Fax
: 804-282-5431
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1992700793 -
DR.
DR.
FREDERICK
L
BLOOM
M.D.
Other Name
:
Mailing Address
:
2650 BAHIA VISTA ST
STE 304
SARASOTA
FL
34239-2634
Phone
: 941-366-9711;
Fax
: 941-957-0079;
Practice Location Address
:
2650 BAHIA VISTA ST
, STE 304
, SARASOTA
, FL
, 34239-2634
Practice Phone
: 941-366-9711;
Practice Fax
: 941-957-0079
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1801891601 -
DR.
DR.
EVA
DOYLE
MARKWARD
O.D.
Other Name
:
EVA
DOYLE
Mailing Address
:
738 DEKALB PIKE
BLUE BELL
PA
19422-1292
Phone
: 610-278-9026;
Fax
: 610-278-9027;
Practice Location Address
:
738 DEKALB PIKE
,
, BLUE BELL
, PA
, 19422-1292
Practice Phone
: 610-278-9026;
Practice Fax
: 610-278-9027
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1710982517 -
DR.
DR.
MICHAEL
KEITH
DAVENPORT
MD
Other Name
:
Mailing Address
:
PO BOX 635283
CINCINNATI
OH
45263-5283
Phone
: 859-344-1600;
Fax
: 859-344-0091;
Practice Location Address
:
20 MEDICAL VILLAGE DR STE 254
,
, EDGEWOOD
, KY
, 41017-5401
Practice Phone
: 859-344-1600;
Practice Fax
: 859-344-0091
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1629073424 -
WILLIAM
ALBERT
TANGUAY
M.D.
Other Name
:
Mailing Address
:
1 PARKWAY
HAVERHILL
MA
01830-6278
Phone
: 978-521-3270;
Fax
: 978-374-8479;
Practice Location Address
:
1 PARKWAY
,
, HAVERHILL
, MA
, 01830-6278
Practice Phone
: 978-521-3270;
Practice Fax
: 978-374-8479
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1538164330 -
LAURA
KAY
FIELDS
NP
Other Name
:
Mailing Address
:
550 S LANDMARK AVE
BLOOMINGTON
IN
47403-3239
Phone
: 812-330-3689;
Fax
: 812-331-3656;
Practice Location Address
:
550 S LANDMARK AVE
,
, BLOOMINGTON
, IN
, 47403-3239
Practice Phone
: 812-330-3689;
Practice Fax
: 812-331-3656
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1447255245 -
DR.
DR.
GREGORY
E
PETERSON
D.O.
Other Name
:
Mailing Address
:
1510 PLEASANT VIEW DR
DES MOINES
IA
50315-2126
Phone
: 515-771-2527;
Fax
: 855-642-1942;
Practice Location Address
:
1510 PLEASANT VIEW DR
,
, DES MOINES
, IA
, 50315-2126
Practice Phone
: 515-771-2527;
Practice Fax
: 855-642-1942
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1356346159 -
DR.
DR.
WARREN
HUNTER
MARROW
DDS
Other Name
:
Mailing Address
:
1550 W ROSEDALE ST
STE 510
FORT WORTH
TX
76104-7409
Phone
: 817-877-0900;
Fax
: 817-877-0977;
Practice Location Address
:
1550 W ROSEDALE ST
, STE 510
, FORT WORTH
, TX
, 76104-7409
Practice Phone
: 817-877-0900;
Practice Fax
: 817-877-0977
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1265437065 -
THANGAM
T
MALAISOODUMPERUMAL
MD
Other Name
:
Mailing Address
:
PO BOX 2005
EAST SYRACUSE
NY
13057-4505
Phone
: 315-449-0513;
Fax
: 315-445-2936;
Practice Location Address
:
736 IRVING AVE
,
, SYRACUSE
, NY
, 13210-1687
Practice Phone
: 315-470-7828;
Practice Fax
: 315-470-5811
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1174528970 -
DR.
DR.
BRION
P
MORAN
M.D.
Other Name
:
Mailing Address
:
3650 MUDDY CREEK RD
SUITE 100
CINCINNATI
OH
45238-2057
Phone
: 513-451-0500;
Fax
: 513-451-0210;
Practice Location Address
:
3301 MERCY HEALTH BLVD
, SUITE 450
, CINCINNATI
, OH
, 45211-1105
Practice Phone
: 513-981-6784;
Practice Fax
: 513-215-9397
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1083619886 -
JOHN
M
HARRIS
M.D.
Other Name
:
Mailing Address
:
PO BOX 936
LONDON
KY
40743-0936
Phone
: ;
Fax
: 606-330-7825;
Practice Location Address
:
1401 HARRODSBURG RD STE B355
,
, LEXINGTON
, KY
, 40504
Practice Phone
: 859-276-5262;
Practice Fax
: 859-277-6509
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1891790697 -
BRUCE
M
BELIN
MD
Other Name
:
Mailing Address
:
2620 WILHITE DR
LEXINGTON
KY
40503-3385
Phone
: 859-278-6031;
Fax
: 859-277-7015;
Practice Location Address
:
2620 WILHITE DR
,
, LEXINGTON
, KY
, 40503-3385
Practice Phone
: 859-278-6031;
Practice Fax
: 859-277-7015
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1700881505 -
LIFE CARE AT HOME OF UTAH, INC.
Other Name
:
Mailing Address
:
3001 KEITH ST NW
CLEVELAND
TN
37312-3713
Phone
: 423-473-5280;
Fax
: 423-339-8369;
Practice Location Address
:
2200 WEST PARKWAY BLVD
, STE 200
, SALT LAKE CITY
, UT
, 84119-2099
Practice Phone
: 801-973-0217;
Practice Fax
: 801-973-0229
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1619972411 -
EULON
ROSS
TAYLOR
M.D.
Other Name
:
Mailing Address
:
4110 GUADALUPE ST
AUSTIN STATE HOSPITAL
AUSTIN
TX
78751-4223
Phone
: 512-419-2148;
Fax
: 512-419-2163;
Practice Location Address
:
4110 GUADALUPE ST
, AUSTIN STATE HOSPITAL
, AUSTIN
, TX
, 78751-4223
Practice Phone
: 512-419-2148;
Practice Fax
: 512-419-2163
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1528063328 -
PATRICE
K
RAWLINS
ARNP
Other Name
:
Mailing Address
:
3243 E MURDOCK ST
SUITE #500
WICHITA
KS
67208-3052
Phone
: 316-962-2080;
Fax
: 316-962-2079;
Practice Location Address
:
3243 E MURDOCK ST
, SUITE #500
, WICHITA
, KS
, 67208-3052
Practice Phone
: 316-962-2080;
Practice Fax
: 316-962-2079
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1437154234 -
CHANDRESHKUMAR
S
SHAH
MD
Other Name
:
Mailing Address
:
2139 AUBURN AVE
CINCINNATI
OH
45219-2906
Phone
: ;
Fax
: ;
Practice Location Address
:
2139 AUBURN AVE
,
, CINCINNATI
, OH
, 45219-2906
Practice Phone
: 513-369-2000;
Practice Fax
:
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1346245149 -
DR.
DR.
KEVIN
CLANCY
M.D.
Other Name
:
Mailing Address
:
368 LAKEHURST RD
STE 301
TOMS RIVER
NJ
08755-7339
Phone
: 732-240-1048;
Fax
: 732-240-3464;
Practice Location Address
:
368 LAKEHURST RD
, STE 301
, TOMS RIVER
, NJ
, 08755-7339
Practice Phone
: 732-240-1048;
Practice Fax
: 732-240-3464
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1255336053 -
DONNA
M
JAMIESON
M.D.
Other Name
:
Mailing Address
:
2650 BAHIA VISTA ST
STE 304
SARASOTA
FL
34239-2634
Phone
: 941-366-9711;
Fax
: 941-957-0079;
Practice Location Address
:
2650 BAHIA VISTA ST
, STE 304
, SARASOTA
, FL
, 34239-2634
Practice Phone
: 941-366-9711;
Practice Fax
: 941-957-0079
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1164427969 -
DR.
DR.
CHAD
MICHAEL
BELANGER
OD
Other Name
:
Mailing Address
:
131 MAIN ST
ONEIDA
NY
13421-1645
Phone
: 225-328-2499;
Fax
: 225-328-2499;
Practice Location Address
:
5801 MAIN ST
,
, ZACHARY
, LA
, 70791-4028
Practice Phone
: 225-654-1176;
Practice Fax
: 225-654-3047
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1073518874 -
DR.
DR.
FOREST
THOMAS
HEIS
MD
Other Name
:
Mailing Address
:
560 S LOOP RD
EDGEWOOD
KY
41017-3405
Phone
: 859-301-2663;
Fax
: 859-817-7848;
Practice Location Address
:
2626 ALEXANDRIA PIKE STE 100
,
, HIGHLAND HEIGHTS
, KY
, 41076-1530
Practice Phone
: 859-301-2663;
Practice Fax
: 859-817-7848
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1982609780 -
TIMOTHY
J
RICCARDI
MD
Other Name
:
Mailing Address
:
PO BOX 2003
EAST SYRACUSE
NY
13057-4503
Phone
: 315-446-3904;
Fax
: 315-445-2936;
Practice Location Address
:
4900 BROAD RD
, STE 3P
, SYRACUSE
, NY
, 13215-2265
Practice Phone
: 315-492-5910;
Practice Fax
: 315-492-5950
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1790780591 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1609871409 -
ASSOCIATED FAMILY HOME CARE INC
Other Name
:
Mailing Address
:
256 SCHUYLER AVENUE
KINGSTON
PA
18704-3322
Phone
: 570-283-5917;
Fax
: 570-763-0067;
Practice Location Address
:
256 SCHUYLER AVENUE
,
, KINGSTON
, PA
, 18704-3322
Practice Phone
: 570-283-5917;
Practice Fax
: 570-763-0067
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1053316869 -
UMANG
M
PATEL
MD
Other Name
:
Mailing Address
:
901 SAINT MARYS DR STE 300
EVANSVILLE
IN
47714-0521
Phone
: ;
Fax
: ;
Practice Location Address
:
901 SAINT MARYS DR
, STE 300
, EVANSVILLE
, IN
, 47714-0520
Practice Phone
: 812-473-2642;
Practice Fax
: 812-474-4458
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1962407775 -
DR.
DR.
DAVID
A.
GLASS
DDS
Other Name
:
Mailing Address
:
4613 CASPER CT
VIRGINIA BEACH
VA
23462-4601
Phone
: 757-495-1692;
Fax
: ;
Practice Location Address
:
1647 ADMIRAL TAUSSIG BLVD
, NAVAL DENTAL CLINIC
, NORFOLK
, VA
, 23511-2803
Practice Phone
: 757-314-6546;
Practice Fax
:
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1871598680 -
DR.
DR.
KEVIN
THOMAS
DAVIS
D.C.
Other Name
:
Mailing Address
:
432 N COCHRAN AVE
CHARLOTTE
MI
48813-1126
Phone
: 517-543-2920;
Fax
: 517-543-1221;
Practice Location Address
:
432 N COCHRAN AVE
,
, CHARLOTTE
, MI
, 48813-1126
Practice Phone
: 517-543-2920;
Practice Fax
: 517-543-1221
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1780689596 -
MR.
MR.
CARL
ANTHONY
SMITH
RPH
Other Name
:
Mailing Address
:
1829 OAK LODGE DR
PEARLAND
TX
77581-6195
Phone
: 281-992-6304;
Fax
: 281-992-2056;
Practice Location Address
:
7550 OFFICE CITY DR
,
, HOUSTON
, TX
, 77012-4115
Practice Phone
: 713-495-3715;
Practice Fax
: 713-495-3717
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1598760308 -
DAVID
S
FELDMAN
MD
Other Name
:
Mailing Address
:
901 45TH ST
KIMMEL BLDG
WEST PALM BEACH
FL
33407-2413
Phone
: 561-844-5255;
Fax
: 561-844-5245;
Practice Location Address
:
901 45TH ST
, KIMMEL BLDG
, WEST PALM BEACH
, FL
, 33407-2413
Practice Phone
: 561-844-5255;
Practice Fax
: 561-844-5245
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1407851215 -
JOSEPH
E
TEMMING
MD
Other Name
:
Mailing Address
:
2616 LEGENDS WAY
CRESTVIEW HILLS
KY
41017-2418
Phone
: 859-331-3100;
Fax
: 859-331-9147;
Practice Location Address
:
2616 LEGENDS WAY
,
, CRESTVIEW HILLS
, KY
, 41017-2418
Practice Phone
: 859-331-3100;
Practice Fax
: 859-331-9147
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1316942121 -
CLARK
A
DAVIS
MD
Other Name
:
Mailing Address
:
1836 SOUTH AVE
LA CROSSE
WI
54601-5429
Phone
: 608-782-7300;
Fax
: ;
Practice Location Address
:
1836 SOUTH AVE
,
, LA CROSSE
, WI
, 54601-5429
Practice Phone
: 608-782-7300;
Practice Fax
:
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1225033038 -
DR.
DR.
JIN
HONG
PARK
MD
Other Name
:
Mailing Address
:
ONE GI CREDENTIALING DEPARTMENT
PO BOX 381468
GERMANTOWN
TN
38183-1468
Phone
: ;
Fax
: ;
Practice Location Address
:
8640 SUDLEY RD STE 201
,
, MANASSAS
, VA
, 20110-4404
Practice Phone
: 703-368-6819;
Practice Fax
: 703-330-2923
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1134124944 -
JALAL
SADRIEH
MD
Other Name
:
Mailing Address
:
PO BOX 2003
EAST SYRACUSE
NY
13057-4503
Phone
: 315-446-3904;
Fax
: 315-445-2936;
Practice Location Address
:
4900 BROAD RD
, STE NORTH3E
, SYRACUSE
, NY
, 13215-2265
Practice Phone
: 315-492-5864;
Practice Fax
: 315-492-5285
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1043215858 -
NORTHEAST SURGICAL CARE OF NEWINGTON, LLC
Other Name
:
Mailing Address
:
1A BURTON HILLS BLVD
ATTN: L&C
NASHVILLE
TN
37215-6103
Phone
: 615-665-1283;
Fax
: 615-234-1720;
Practice Location Address
:
2299 WOODBURY AVENUE
, SUITE 5
, NEWINGTON
, NH
, 03801-7854
Practice Phone
: 603-431-5563;
Practice Fax
: 603-431-2544
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1952306763 -
DR.
DR.
EUGENE
JOSEPH
SIMONI
M.D.
Other Name
:
Mailing Address
:
PO BOX 858
MC A410
HERSHEY
PA
17033-0858
Phone
: 800-243-1455;
Fax
: ;
Practice Location Address
:
303 BENNER PIKE STE 1
,
, STATE COLLEGE
, PA
, 16801-7304
Practice Phone
: 814-272-5660;
Practice Fax
: 814-272-5675
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1861497679 -
ROBERT
L
SUGAR
M.D.
Other Name
:
Mailing Address
:
8901 W 74TH ST
STE 248
SHAWNEE MISSION
KS
66204-2202
Phone
: 913-384-4990;
Fax
: 913-384-1310;
Practice Location Address
:
8901 W 74TH ST
, STE 248
, SHAWNEE MISSION
, KS
, 66204-2202
Practice Phone
: 913-384-4990;
Practice Fax
: 913-384-1310
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1770588584 -
PHYSICIANS SURGERY CENTER LLC
Other Name
:
Mailing Address
:
PO BOX 715803
CINCINNATI
OH
45271-5803
Phone
: 239-788-0604;
Fax
: 239-230-0041;
Practice Location Address
:
4035 EVANS AVE
,
, FT MYERS
, FL
, 33901-9308
Practice Phone
: 239-788-0604;
Practice Fax
: 239-230-0041
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1689679490 -
DR.
DR.
LANCE
SETH
BERGER
M.D.
Other Name
:
Mailing Address
:
780 ROUTE 37 W STE 310
TOMS RIVER
NJ
08755-5059
Phone
: 732-473-0158;
Fax
: ;
Practice Location Address
:
780 ROUTE 37 W STE 310
,
, TOMS RIVER
, NJ
, 08755-5059
Practice Phone
: 732-473-0158;
Practice Fax
:
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1497750202 -
GEORGE
H
NORTHRUP
PH.D.
Other Name
:
Mailing Address
:
7710 HEWLETT ST
NEW HYDE PARK
NY
11040-1461
Phone
: 718-343-9300;
Fax
: 718-347-2982;
Practice Location Address
:
7710 HEWLETT ST
,
, NEW HYDE PARK
, NY
, 11040-1461
Practice Phone
: 718-343-9300;
Practice Fax
: 718-347-2982
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1306841119 -
VICTOR
TORRES
DPM
Other Name
:
Mailing Address
:
910 MOUNT HOMER RD
EUSTIS
FL
32726-6258
Phone
: 352-357-8615;
Fax
: 357-357-5873;
Practice Location Address
:
910 MOUNT HOMER RD
,
, EUSTIS
, FL
, 32726-6258
Practice Phone
: 352-357-8615;
Practice Fax
: 357-357-5873
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1215932025 -
JANET
HUDGINS
DEHOUX
NP
Other Name
:
Mailing Address
:
856 J CLYDE MORRIS BLVD
SUITE A
NEWPORT NEWS
VA
23601-1318
Phone
: ;
Fax
: ;
Practice Location Address
:
7547 MEDICAL DR
, SUITE 1200
, GLOUCESTER
, VA
, 23061-4351
Practice Phone
: 804-693-2670;
Practice Fax
: 804-693-3704
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1124023932 -
MS.
MS.
AGNES
SHIRLEY
PARKER
ARNP
Other Name
:
Mailing Address
:
107 S DIVISION ST
SPOKANE
WA
99202-1510
Phone
: 509-838-4651;
Fax
: 509-363-2762;
Practice Location Address
:
1412 RIDGEWOOD PARK RD
,
, MEMPHIS
, TN
, 38116-7214
Practice Phone
: 901-345-5401;
Practice Fax
:
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1033114848 -
KYOUNG
SOO
BAE
M.D.
Other Name
:
Mailing Address
:
36175 HARPER AVE
CLINTON TOWNSHIP
MI
48035-3274
Phone
: 586-741-3772;
Fax
: 586-741-4604;
Practice Location Address
:
36175 HARPER AVE
,
, CLINTON TOWNSHIP
, MI
, 48035-3274
Practice Phone
: 586-741-3772;
Practice Fax
: 586-741-4604
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1942205752 -
JEFFREY
J
DAVIS
MD
Other Name
:
Mailing Address
:
1501 NE MEDICAL CENTER DR
BEND
OR
97701-6051
Phone
: 541-382-2811;
Fax
: 541-706-6462;
Practice Location Address
:
1501 NE MEDICAL CENTER DR
,
, BEND
, OR
, 97701-6051
Practice Phone
: 541-382-2811;
Practice Fax
: 541-706-6462
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1851396667 -
DR.
DR.
ROBERT
CRAIG
CAIN
DDS
Other Name
:
Mailing Address
:
2040 CASTAIC LN
KNOXVILLE
TN
37932-1557
Phone
: 865-246-0460;
Fax
: 865-482-0592;
Practice Location Address
:
2040 CASTAIC LN
,
, KNOXVILLE
, TN
, 37932-1557
Practice Phone
: 865-246-0460;
Practice Fax
: 865-482-0592
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1760487573 -
JERRY
A
DAVIS
MD
Other Name
:
Mailing Address
:
1836 SOUTH AVE
LA CROSSE
WI
54601-5429
Phone
: 608-782-7300;
Fax
: ;
Practice Location Address
:
1836 SOUTH AVE
,
, LA CROSSE
, WI
, 54601-5429
Practice Phone
: 608-782-7300;
Practice Fax
:
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1679578488 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1588669394 -
MICHAEL
A
MCCORMACK
MPT
Other Name
:
Mailing Address
:
7423 S MASON MONTGOMERY RD
MASON
OH
45040-7828
Phone
: 513-347-9999;
Fax
: 513-573-9178;
Practice Location Address
:
7423 S MASON MONTGOMERY RD
,
, MASON
, OH
, 45040-7828
Practice Phone
: 513-347-9999;
Practice Fax
: 513-573-9178
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1396740106 -
KRISTINE
CARLSTEN
SALVO
MD
Other Name
:
Mailing Address
:
9524 BELAIR RD
BALTIMORE
MD
21236-1508
Phone
: 410-529-9311;
Fax
: ;
Practice Location Address
:
9524 BELAIR RD
,
, BALTIMORE
, MD
, 21236-1508
Practice Phone
: 410-529-9311;
Practice Fax
:
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1205831013 -
CARROLL COUNTY MEMORIAL HOSPITAL
Other Name
:
Mailing Address
:
1502 N JEFFERSON ST
CARROLLTON
MO
64633-1948
Phone
: 660-542-3301;
Fax
: 660-542-1691;
Practice Location Address
:
1502 N JEFFERSON ST
,
, CARROLLTON
, MO
, 64633-1948
Practice Phone
: 660-542-3301;
Practice Fax
: 660-542-1691
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