Mr Buddy Wayne Lile, MD | |
550 Main Street, Suite 230, New Brighton, MN 55112 | |
(612) 326-7558 | |
(612) 454-2087 |
Full Name | Mr Buddy Wayne Lile |
---|---|
Gender | Male |
Speciality | Psychiatry |
Experience | 30 Years |
Location | 550 Main Street, New Brighton, Minnesota |
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 |
---|---|---|---|
1104858612 | NPI | - | NPPES |
042-0010705 | Other | VT | VERMONT STATE LICENSE |
1010386 | Medicaid | MN | |
1010386 | Medicaid | VT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 042-0010705 (Vermont) | Secondary |
2084P0800X | Psychiatry & Neurology - Psychiatry | 49329 (Minnesota) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Christus St Vincent Regional Medical Center | Santa fe, NM | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
St. Vincent Hospital | 6608775135 | 271 |
Entity Name | St. Vincent Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1578587150 PECOS PAC ID: 6608775135 Enrollment ID: O20040105000372 |
Mailing Address | Practice Location Address |
---|---|
Mr Buddy Wayne Lile, MD 550 Main Street, Suite 230, New Brighton, MN 55112 Ph: (612) 326-7558 | Mr Buddy Wayne Lile, MD 550 Main Street, Suite 230, New Brighton, MN 55112 Ph: (612) 326-7558 |
Edward Loon Chua, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112 Phone: 651-328-9566 | |
Lauren Nievinski, PA-C Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1900 Silver Lake Rd Nw, New Brighton, MN 55112 Phone: 651-529-8315 | |
Dr. Tina S. Thakrar, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112 Phone: 651-628-9566 Fax: 651-628-0411 | |
Jonathan Charles Uecker, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112 Phone: 651-628-9566 Fax: 651-628-0411 | |
Dr. Daniel Joe Albee, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 2475 15th St Nw, Suite D, New Brighton, MN 55112 Phone: 651-636-0308 Fax: 651-697-1209 | |
Thomas Frederick Micka, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112 Phone: 651-628-9566 |