Dr Theodore Joseph Jerdee, MD | |
101 Bodin Cir, 60 Mdg/sgqx, Travis Afb, CA 94535-1809 | |
(707) 423-7182 | |
Not Available |
Full Name | Dr Theodore Joseph Jerdee |
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Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 101 Bodin Cir, Travis Afb, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1104806397 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2085R0202X | Radiology - Diagnostic Radiology | C53747 (California) | Primary |
208D00000X | General Practice | 22461 (Oklahoma) | Secondary |
Entity Name | John Muir Trauma Physicians Billing Service |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093864837 PECOS PAC ID: 3476542515 Enrollment ID: O20050420001452 |
Mailing Address | Practice Location Address |
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Dr Theodore Joseph Jerdee, MD 101 Bodin Cir, 60 Mdg/sgqx, Travis Afb, CA 94535-1809 Ph: () - | Dr Theodore Joseph Jerdee, MD 101 Bodin Cir, 60 Mdg/sgqx, Travis Afb, CA 94535-1809 Ph: (707) 423-7182 |
Dr. Teddy Jinnteh Su, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 101 Bodin Cir, 60th Medical Group, Travis Afb, CA 94535 Phone: 707-423-7181 | |
Dr. Zoltan A. Varro, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-7182 | |
James Odone, Radiology Medicare: Accepting Medicare Assignments Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-7182 | |
Dr. Lance Dustin Edmonds, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 101 Bodin Cir, Mdts/sgqx, Travis Afb, CA 94535 Phone: 707-423-7182 | |
Winnifred Wong, DO Radiology Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-7691 | |
Dr. Marvin Glass Jr., PHD Radiology Medicare: Not Enrolled in Medicare Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-5119 |