Mark Fleming, | |
305 W Jackson St Ste 103, Carbondale, IL 62901-1474 | |
(618) 351-4972 | |
(618) 351-6522 |
Full Name | Mark Fleming |
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Gender | Male |
Speciality | Neurological Surgery |
Location | 305 W Jackson St Ste 103, Carbondale, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508807181 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207T00000X | Neurological Surgery | 35-058145 F (Ohio) | Secondary |
207T00000X | Neurological Surgery | 036.130895 (Illinois) | Primary |
Entity Name | Southern Illinois Medical Services Nfp |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595 |
Mailing Address | Practice Location Address |
---|---|
Mark Fleming, Po Box 3988, Carbondale, IL 62902-3988 Ph: (618) 457-5200 | Mark Fleming, 305 W Jackson St Ste 103, Carbondale, IL 62901-1474 Ph: (618) 351-4972 |
Dr. Gordon Kt Chu, M.D. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 305 W Jackson St Ste 400, Carbondale, IL 62901 Phone: 618-351-4972 Fax: 618-351-4973 | |
Eugenio Fortunato Vargas, MD Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 305 W Jackson St Ste 400, Carbondale, IL 62901 Phone: 618-351-4972 Fax: 618-351-4973 | |
Dr. Dongwoo John Chang, M.D. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 305 W Jackson St Ste 400, Carbondale, IL 62901 Phone: 618-351-4972 Fax: 618-351-4973 |