Dr Jeffrey Allan Banks, MD | |
420 Polifka Dr Bldg 1042, Shaw Afb, SC 29152-5100 | |
(803) 895-6356 | |
(803) 895-6040 |
Full Name | Dr Jeffrey Allan Banks |
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Gender | Male |
Speciality | Pediatrics |
Location | 420 Polifka Dr Bldg 1042, Shaw Afb, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083699300 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 2010-01016 (North Carolina) | Secondary |
208000000X | Pediatrics | 7284 (Alaska) | Primary |
171000000X | Military Health Care Provider | ME85849 (Florida) | Secondary |
Entity Name | Tanana Valley Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922559558 PECOS PAC ID: 5698056901 Enrollment ID: O20161228001991 |
Mailing Address | Practice Location Address |
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Dr Jeffrey Allan Banks, MD 420 Polifka Dr Bldg 1042, Shaw Afb, SC 29152-5100 Ph: (803) 895-6356 | Dr Jeffrey Allan Banks, MD 420 Polifka Dr Bldg 1042, Shaw Afb, SC 29152-5100 Ph: (803) 895-6356 |
Rebecca Sarah Slogic, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 420 Polifka Dr Bldg 1042, Shaw Afb, SC 29152 Phone: 803-895-6356 | |
Dr. Dominic Anthony Defrancis, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 420 Polifka Dr Bldg 1042, Shaw Afb, SC 29152 Phone: 803-895-6356 |