Mark Edmund Thompson, DO | |
4520 W Us Highway 90, Lake City, FL 32055-8341 | |
(352) 755-0601 | |
(352) 755-0602 |
Full Name | Mark Edmund Thompson |
---|---|
Gender | Male |
Speciality | Radiation Oncology |
Experience | 41 Years |
Location | 4520 W Us Highway 90, Lake City, Florida |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487646030 | NPI | - | NPPES |
310302 | Other | FL | AVMED |
279300800 | Medicaid | FL | |
0825156 | Medicaid | OH | |
PTAN AG644E | Other | FL | LINKED TO GROUP PTAN IE881A EFFECTIVE 08/01/2015 |
02484 | Other | FL | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0001X | Radiology - Radiation Oncology | OS10194 (Florida) | Secondary |
2085R0203X | Radiology - Therapeutic Radiology | OS10194 (Florida) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Lake City Cancer Care Llc | 7315250685 | 5 |
Entity Name | Lake City Cancer Care Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396132213 PECOS PAC ID: 7315250685 Enrollment ID: O20150715000887 |
Mailing Address | Practice Location Address |
---|---|
Mark Edmund Thompson, DO 4520 W Us Highway 90, Lake City, FL 32055-8341 Ph: (352) 755-0601 | Mark Edmund Thompson, DO 4520 W Us Highway 90, Lake City, FL 32055-8341 Ph: (352) 755-0601 |
Dr. Mary Hamer, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: Vamc, Marion St., Lake City, FL 32025 Phone: 386-755-3016 | |
Pachagiri L Suresh, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 619 S Marion Ave, Lake City, FL 32025 Phone: 386-755-3016 | |
Ricardo Bedoya-garcia, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 183 Nw Gwen Lake Ave, Lake City, FL 32055 Phone: 386-752-9144 Fax: 386-752-5881 | |
Ashley Nobles, R.T.(R) Radiology Medicare: Not Enrolled in Medicare Practice Location: 619 S Marion Ave, Lake City, FL 32025 Phone: 386-755-3016 |