Dr Michael M Fox, MD | |
6563 Stage Oaks Dr, Suite 100, Bartlett, TN 38134-2886 | |
(901) 362-5252 | |
(901) 572-1264 |
Full Name | Dr Michael M Fox |
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Gender | Male |
Speciality | Surgery |
Location | 6563 Stage Oaks Dr, Bartlett, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942293063 | NPI | - | NPPES |
03752259 | Medicaid | MS | |
3325162 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 19455 (Mississippi) | Secondary |
208600000X | Surgery | 36972 (Tennessee) | Primary |
Entity Name | Mid-south Rectal Clinic, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316024193 PECOS PAC ID: 1052375300 Enrollment ID: O20041116000800 |
Mailing Address | Practice Location Address |
---|---|
Dr Michael M Fox, MD 7550 Lucerne Dr, Suite 405, Middleburg Hts, OH 44130-6530 Ph: (440) 234-8833 | Dr Michael M Fox, MD 6563 Stage Oaks Dr, Suite 100, Bartlett, TN 38134-2886 Ph: (901) 362-5252 |
Melvin Pelletier Payne Iii, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2996 Kate Bond Rd, Suite 309, Bartlett, TN 38133 Phone: 901-726-1056 Fax: 901-726-5867 | |
David Benjamin Gibson, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2996 Kate Bond Rd, Suite 309, Bartlett, TN 38133 Phone: 901-726-1056 Fax: 901-726-5867 | |
Mrs. Aimee Katharine Tutton, CST, CSFA Surgery Medicare: Not Enrolled in Medicare Practice Location: 2986 Kate Bond Rd, Bartlett, TN 38133 Phone: 901-820-7460 | |
Crystal Adrienne Hayes, Surgery Medicare: Not Enrolled in Medicare Practice Location: 2986 Kate Bond Rd, Bartlett, TN 38133 Phone: 901-820-7460 | |
Debra Shannon, Surgery Medicare: Not Enrolled in Medicare Practice Location: 2986 Kate Bond Rd, Bartlett, TN 38133 Phone: 901-820-7460 |