Mr Jack Michael Friday, MD | |
3024 Business Park Cir, Goodlettsville, TN 37072-3132 | |
(615) 851-6033 | |
(615) 851-2018 |
Full Name | Mr Jack Michael Friday |
---|---|
Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 3024 Business Park Cir, Goodlettsville, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700825940 | NPI | - | NPPES |
3031174 | Other | TN | BCBS |
4291356 | Other | TN | BCBS - MTI |
1509266 | Other | TN | MEDICAID - MTI |
300108653 | Other | TN | RAILROAD MEDICARE |
3083732 | Medicaid | TN | |
3136571 | Other | TN | BCBS |
4200799 | Other | TN | BCBS TN |
64924590 | Other | KY | KY MEDICAID |
6492459000 | Medicaid | KY | |
1509266 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | MD25800 (Tennessee) | Primary |
2085R0204X | Radiology - Vascular & Interventional Radiology | 25800 (Tennessee) | Secondary |
Entity Name | Columbia St Marys Hospital Milwaukee Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023064482 PECOS PAC ID: 5890604722 Enrollment ID: O20031105000057 |
Mailing Address | Practice Location Address |
---|---|
Mr Jack Michael Friday, MD 3024 Business Park Cir, Goodlettsville, TN 37072-3132 Ph: (615) 851-6033 | Mr Jack Michael Friday, MD 3024 Business Park Cir, Goodlettsville, TN 37072-3132 Ph: (615) 851-6033 |
Mr. Marc G Soble, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3024 Business Park Cir, Goodlettsville, TN 37072 Phone: 615-851-6033 Fax: 615-851-2018 | |
Melinda Rixey Sava, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3024 Business Park Cir, Goodlettsville, TN 37072 Phone: 615-851-6033 Fax: 615-851-2018 | |
Mr. Lawrence D Lubow, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3024 Business Park Cir, Goodlettsville, TN 37072 Phone: 615-851-6033 Fax: 615-851-2018 | |
Dr. John J Nisbet, MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 3024 Business Park Cir, Goodlettsville, TN 37072 Phone: 615-851-6033 Fax: 615-234-1502 | |
Mr. Michael C Ellis, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3024 Business Park Cir, Goodlettsville, TN 37072 Phone: 615-851-6033 Fax: 615-851-2018 | |
Dr. Jonathan Paul Gordon, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3024 Business Park Cir, Goodlettsville, TN 37072 Phone: 615-851-6033 Fax: 615-851-2018 | |
Dr. Matthew Renaud Bernhard, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3024 Business Park Cir, Goodlettsville, TN 37072 Phone: 615-851-6033 Fax: 615-851-2018 |