Dr Robert J Tallaksen, MD | |
101 Stadium Dr, Morgantown, WV 26506-7911 | |
(304) 598-4000 | |
(304) 293-6963 |
Full Name | Dr Robert J Tallaksen |
---|---|
Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 101 Stadium Dr, Morgantown, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154381309 | NPI | - | NPPES |
0123739000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 13427 (West Virginia) | Primary |
Entity Name | West Virginia University Medical Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275504508 PECOS PAC ID: 1052224565 Enrollment ID: O20031111000207 |
Mailing Address | Practice Location Address |
---|---|
Dr Robert J Tallaksen, MD Po Box 897, Morgantown, WV 26507-0897 Ph: (304) 293-7401 | Dr Robert J Tallaksen, MD 101 Stadium Dr, Morgantown, WV 26506-7911 Ph: (304) 598-4000 |
Robert Grammer, Radiology Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Center Dr, Morgantown, WV 26506 Phone: 304-598-4000 | |
Brian Markovich, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Center Dr, Morgantown, WV 26506 Phone: 304-293-3091 | |
Mithra Kimyai-asadi, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 101 Stadium Dr, Morgantown, WV 26506 Phone: 304-293-2463 | |
Dr. Gary D Marano, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 101 Stadium Dr, Morgantown, WV 26506 Phone: 304-598-4000 Fax: 304-293-6963 | |
Larissa Casaburi, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 6040 University Town Centre Dr, Morgantown, WV 26501 Phone: 304-293-6307 | |
Zalak Patel, Radiology Medicare: Medicare Enrolled Practice Location: 1 Medical Center Dr, Morgantown, WV 26506 Phone: 304-293-2463 Fax: 304-293-5160 |