Dr Gerald Thomas Russell, MD | |
11130 Kingston Pike, Suite 7&8, Farragut, TN 37934-2865 | |
(865) 675-1953 | |
Not Available |
Full Name | Dr Gerald Thomas Russell |
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Gender | Male |
Speciality | Family Medicine |
Location | 11130 Kingston Pike, Farragut, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043200603 | NPI | - | NPPES |
31906521 | Medicaid | TN | |
3706633 | Other | TN | MEDICARE GROUP |
3706633 | Other | TN | MEDICAID GROUP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MD0000012638 (Tennessee) | Primary |
Entity Name | Summit Medical Group, Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659090298 PECOS PAC ID: 2860396330 Enrollment ID: O20031125000793 |
Mailing Address | Practice Location Address |
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Dr Gerald Thomas Russell, MD 1225 E Weisgarber Rd, Suite 200, Knoxville, TN 37909-2604 Ph: (865) 584-4747 | Dr Gerald Thomas Russell, MD 11130 Kingston Pike, Suite 7&8, Farragut, TN 37934-2865 Ph: (865) 675-1953 |
James Kevin Buchanan, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 11130 Kingston Pike, Suite 7&8, Farragut, TN 37934 Phone: 865-675-1953 | |
John Lynn Law, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 11130 Kingston Pike, Suite 7&8, Farragut, TN 37934 Phone: 865-675-1953 | |
Welborn David England, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 11130 Kingston Pike, Suite 7&8, Farragut, TN 37934 Phone: 865-675-1953 | |
Dr. Richard W Mattison, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 11130 Kingston Pike Ste 7&8, Farragut, TN 37934 Phone: 865-675-1953 Fax: 865-675-0877 |