Martin Leboutillier Iii, MD | |
Fourth & Walnut Sts, 2nd Fl, Lebanon, PA 17042-1281 | |
(717) 270-3751 | |
(717) 270-3754 |
Full Name | Martin Leboutillier Iii |
---|---|
Gender | Male |
Speciality | Thoracic Surgery |
Experience | 34 Years |
Location | Fourth & Walnut Sts, Lebanon, Pennsylvania |
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 |
---|---|---|---|
1831152651 | NPI | - | NPPES |
058255700 | Medicaid | MD | |
001708549 | Medicaid | PA | |
30139141 | Other | PA | AMERIHEALTH MERCY-WMG |
976216 | Other | PA | HIGHMARK BLUE SHIELD |
1511587 | Other | PA | GATEWAY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | MD065743L (Pennsylvania) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Wellspan Vna Home Care | York, PA | Home health agency |
Good Samaritan Hospital | Lebanon, PA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Wellspan Medical Group | 1951213115 | 1966 |
Entity Name | Wellspan Medical Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750480299 PECOS PAC ID: 1951213115 Enrollment ID: O20040220000815 |
Mailing Address | Practice Location Address |
---|---|
Martin Leboutillier Iii, MD Fourth & Walnut Sts, 2nd Fl, Lebanon, PA 17042-1281 Ph: (717) 270-3751 | Martin Leboutillier Iii, MD Fourth & Walnut Sts, 2nd Fl, Lebanon, PA 17042-1281 Ph: (717) 270-3751 |
Savas Mavridis, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 252 S 4th St Fl 2, Lebanon, PA 17042 Phone: 717-270-3751 Fax: 717-270-3751 | |
Dr. Mark William Connolly, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 252 S 4th St, Lebanon, PA 17042 Phone: 717-270-3751 | |
Dr. Mohammad Bashar Yousuf, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Medicare Enrolled Practice Location: 252 S 4th St Fl 2, Lebanon, PA 17042 Phone: 717-270-3751 Fax: 717-270-3754 | |
Dr. Mark Allan Osevala, D.O. Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 252 S 4th St Fl 2, Lebanon, PA 17042 Phone: 717-270-3751 Fax: 717-270-3754 | |
Dr. David John Cohen, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 252 S 4th St Fl 2, Lebanon, PA 17042 Phone: 717-270-3751 Fax: 717-270-3754 |