Mr Craig A Ennis, MD | |
647 Dunlop Ln, 210, Clarksville, TN 37040-5165 | |
(931) 502-3810 | |
(931) 502-3815 |
Full Name | Mr Craig A Ennis |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Experience | 34 Years |
Location | 647 Dunlop Ln, Clarksville, Tennessee |
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 |
---|---|---|---|
1295742120 | NPI | - | NPPES |
00G726930 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | G72693 (California) | Secondary |
207RG0100X | Internal Medicine - Gastroenterology | 54629 (Tennessee) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Tennova Healthcare-clarksville | Clarksville, TN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Clarksville Physician Services Gp | 0547276917 | 26 |
Entity Name | Clarksville Physician Services Gp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083657829 PECOS PAC ID: 0547276917 Enrollment ID: O20060223000133 |
Mailing Address | Practice Location Address |
---|---|
Mr Craig A Ennis, MD 647 Dunlop Ln, 210, Clarksville, TN 37040-5165 Ph: (931) 502-3810 | Mr Craig A Ennis, MD 647 Dunlop Ln, 210, Clarksville, TN 37040-5165 Ph: (931) 502-3810 |
Oba Hashim Hollie, M.D. Gastroenterology Medicare: Medicare Enrolled Practice Location: 511 8th St, Clarksville, TN 37040 Phone: 931-245-3580 Fax: 931-201-5868 | |
Jigar Kanubhai Shah, MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 274 Clear Sky Ct, Clarksville Cancer Care, Clarksville, TN 37043 Phone: 931-802-8056 Fax: 931-802-8059 | |
Dr. Fausta Ditah, Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 647 Dunlop Ln Ste 210, Clarksville, TN 37040 Phone: 931-502-3810 Fax: 931-502-3815 | |
Nathan Lidsky, MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 1481 Hollis Rdg, Clarksville, TN 37043 Phone: 847-987-2121 | |
James R Smith, MD Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 344 Peartree Dr, Clarksville, TN 37043 Phone: 931-648-1811 | |
Dr. Sriram Krishnasamy, M.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 298 Clear Sky Ct, Suite B, Clarksville, TN 37043 Phone: 931-542-2647 Fax: 931-542-2648 | |
Vernon M Carrigan, MD Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 490 Dunlop Ln, Clarksville, TN 37040 Phone: 931-245-8300 Fax: 931-245-8360 |