Charles Nicholas Eisenhauer Iv, MD | |
6029 Walnut Grove Rd Ste 404, Memphis, TN 38120-2112 | |
(901) 726-1056 | |
Not Available |
Full Name | Charles Nicholas Eisenhauer Iv |
---|---|
Gender | Male |
Speciality | General Surgery |
Experience | 15 Years |
Location | 6029 Walnut Grove Rd Ste 404, Memphis, Tennessee |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275775587 | NPI | - | NPPES |
57079 | Other | TN | TN STATE LICENSE |
48491 | Other | KY | KY STATE LICENSE |
0148667 | Medicaid | OH | |
7100133120 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | P (Kentucky) | Secondary |
208600000X | Surgery | 71735 (Minnesota) | Primary |
208600000X | Surgery | 57079 (Tennessee) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Avera Marshall Regional Medical Ctr | Marshall, MN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Avera Marshall | 5799695227 | 78 |
Entity Name | Avera Marshall |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568401016 PECOS PAC ID: 5799695227 Enrollment ID: O20031106000219 |
Entity Name | Avera Marshall |
---|---|
Entity Type | Part A Provider - Critical Access Hospital |
Entity Identifiers | NPI Number: 1568401016 PECOS PAC ID: 5799695227 Enrollment ID: O20091209000435 |
Entity Name | Rural Health Care Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215317375 PECOS PAC ID: 3476447541 Enrollment ID: O20150710000034 |
Mailing Address | Practice Location Address |
---|---|
Charles Nicholas Eisenhauer Iv, MD 300 S Bruce St, Marshall, MN 56258-1934 Ph: (507) 537-9165 | Charles Nicholas Eisenhauer Iv, MD 6029 Walnut Grove Rd Ste 404, Memphis, TN 38120-2112 Ph: (901) 726-1056 |
Leonard Harvey Hines, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 6005 Park Ave, Suite 821-b, Memphis, TN 38119 Phone: 901-726-1056 Fax: 901-726-5867 | |
Dr. Robert D Wallace, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1068 Cresthaven Rd Ste 500, Memphis, TN 38119 Phone: 901-866-8525 | |
William Leslie Hickerson, MD Surgery Medicare: Medicare Enrolled Practice Location: 890 Madison Ave, Suite Tg032, Memphis, TN 38103 Phone: 901-448-2579 Fax: 901-448-2602 | |
Dr. Dan Huff Shell Iii, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1068 Cresthaven Rd Ste 200, Memphis, TN 38119 Phone: 901-761-4844 Fax: 901-761-6929 | |
Randall William Franz, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1325 Eastmoreland Ave Ste 365, Memphis, TN 38104 Phone: 901-272-6018 Fax: 901-201-4203 | |
Dr. Christine T Mroz, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 6005 Park, #700, Memphis, TN 38119 Phone: 901-527-3391 Fax: 901-578-3969 | |
Miriam Wing San Tsao, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1211 Union Ave Suite 300, Memphis, TN 38104 Phone: 901-516-0792 Fax: 901-266-6415 |