Mr Kenneth Russell Hardigan, MD | |
100 Lantana Rd Ste 202a, Crossville, TN 38555-1915 | |
(931) 484-5141 | |
(865) 374-2074 |
Full Name | Mr Kenneth Russell Hardigan |
---|---|
Gender | Male |
Speciality | Internal Medicine - Cardiovascular Disease |
Location | 100 Lantana Rd Ste 202a, Crossville, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437148582 | NPI | - | NPPES |
Q074573 | Medicaid | TN | |
000852596A | Medicaid | GA | |
00627327G | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RC0000X | Internal Medicine - Cardiovascular Disease | 039120 (Georgia) | Secondary |
207RC0000X | Internal Medicine - Cardiovascular Disease | 65348 (Tennessee) | Primary |
Entity Name | Covenant Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457302010 PECOS PAC ID: 2860305463 Enrollment ID: O20060719000030 |
Mailing Address | Practice Location Address |
---|---|
Mr Kenneth Russell Hardigan, MD 100 Lantana Rd Ste 202a, Crossville, TN 38555-1915 Ph: (931) 484-5141 | Mr Kenneth Russell Hardigan, MD 100 Lantana Rd Ste 202a, Crossville, TN 38555-1915 Ph: (931) 484-5141 |
Dr. Tamara Jean Collins, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 100 Lantana Rd, Suite 202, Crossville, TN 38555 Phone: 931-484-5141 Fax: 931-484-5620 | |
Mr. Robert E Nichols, MD Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 100 Lantana Rd, Suite 202, Crossville, TN 38555 Phone: 931-484-5141 Fax: 931-484-5620 | |
Dr. Kimberly S Peaslee, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 1645 S Main St, Suite 101, Crossville, TN 38555 Phone: 931-484-7531 Fax: 931-456-9515 | |
Mehran Monazam Tavallaee, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 133 Hayes St, Crossville, TN 38555 Phone: 931-456-9434 Fax: 931-456-5061 | |
Dr. Thomas E Clayton, M.D. Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 1645 S Main St, Suite 101, Crossville, TN 38555 Phone: 931-484-7531 Fax: 931-456-9515 | |
Dr. Mary M Headrick, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 100 Lantana Rd, Suite 202, Crossville, TN 38555 Phone: 931-484-5141 Fax: 931-484-5620 | |
Dr. Kristine Louise Soly, MD, FACC Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 917 Hillcrest Dr, Crossville, TN 38555 Phone: 931-456-5900 Fax: 931-456-5916 |