Brad A Feltis, MD | |
325 N State Of Franklin Rd Fl 3, Johnson City, TN 37604-6171 | |
(423) 439-7201 | |
(423) 438-7219 |
Full Name | Brad A Feltis |
---|---|
Gender | Male |
Speciality | Surgery - Pediatric Surgery |
Location | 325 N State Of Franklin Rd Fl 3, Johnson City, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437110004 | NPI | - | NPPES |
Q057730 | Medicaid | TN | |
108781900 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2086S0120X | Surgery - Pediatric Surgery | 40928 (Minnesota) | Secondary |
2086S0120X | Surgery - Pediatric Surgery | MD60987 (Tennessee) | Primary |
Entity Name | Pediatric Surgical Associates Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093778292 PECOS PAC ID: 3678477544 Enrollment ID: O20031121000636 |
Mailing Address | Practice Location Address |
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Brad A Feltis, MD Po Box 699, Mountain Home, TN 37684-0699 Ph: (423) 439-7201 | Brad A Feltis, MD 325 N State Of Franklin Rd Fl 3, Johnson City, TN 37604-6171 Ph: (423) 439-7201 |
Dr. Melissa A Powell, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 410 N State Of Franklin Rd, Suite 130, Johnson City, TN 37604 Phone: 423-431-2477 Fax: 423-431-2478 | |
Dr. David Northern Walters, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: James H. Quillen/vamc, Corner Of Sidney And Lamont, Johnson City, TN 37684 Phone: 423-926-1171 Fax: 423-979-3477 | |
Dr. Rebecca Erion Odom, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 2333 Knob Creek Rd Ste 16, Johnson City, TN 37604 Phone: 423-975-0764 Fax: 423-975-0141 | |
Michael J Allshouse, DO Surgery Medicare: Medicare Enrolled Practice Location: 325 N State Of Franklin Rd Fl 3, Johnson City, TN 37604 Phone: 423-439-7201 Fax: 423-439-7219 | |
Isaac William Browder, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 325 N State Of Franklin Rd, 3rd Floor, Johnson City, TN 37604 Phone: 423-439-7201 Fax: 423-439-7219 | |
Ryan M Landis, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 410 N State Of Franklin Rd Ste 130, Johnson City, TN 37604 Phone: 423-431-2477 Fax: 423-431-2478 | |
Tony O. Haley, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3 Professional Park Dr Ste 31, Johnson City, TN 37604 Phone: 423-975-5650 Fax: 423-975-5652 |