Omar F Ghandour, MD | |
7601 Southcrest Pkwy, Southaven, MS 38671-4739 | |
(662) 772-2130 | |
(662) 772-2131 |
Full Name | Omar F Ghandour |
---|---|
Gender | Male |
Speciality | Radiation Oncology |
Experience | 33 Years |
Location | 7601 Southcrest Pkwy, Southaven, Mississippi |
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 |
---|---|---|---|
1255323663 | NPI | - | NPPES |
4046696 | Other | TN | BLUE CROSS BLUE SHIELD |
3876529 | Medicaid | TN | |
99465 | Other | AR | BLUE CROSS BLUE SHIELD |
00127062 | Medicaid | MS | |
148872001 | Medicaid | AR | |
7160133 | Other | AETNA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0001X | Radiology - Radiation Oncology | 22217 (Mississippi) | Primary |
2085R0001X | Radiology - Radiation Oncology | 36779 (Tennessee) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Baptist Memorial Hospital Desoto | Southaven, MS | Hospital |
Baptist Memorial Hospital Union County | New albany, MS | Hospital |
Baptist Memorial Hospital Tipton | Covington, TN | Hospital |
Baptist Memorial Hospital | Memphis, TN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Baptist Memorial Medical Group, Inc. | 5193610228 | 432 |
Baptist Memorial Medical Group, Inc. | 5193610228 | 432 |
Entity Name | Baptist Memorial Medical Group, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306089206 PECOS PAC ID: 5193610228 Enrollment ID: O20040218000385 |
Mailing Address | Practice Location Address |
---|---|
Omar F Ghandour, MD Po Box 405827, Atlanta, GA 30384-5827 Ph: () - | Omar F Ghandour, MD 7601 Southcrest Pkwy, Southaven, MS 38671-4739 Ph: (662) 772-2130 |
Samuel G Putnam Iii, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 55 Physicians Ln, Southaven, MS 38671 Phone: 662-655-2136 Fax: 662-996-2214 | |
Loi T Vu, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 7420 Guthrie Dr N Ste 105, Southaven, MS 38671 Phone: 662-349-4321 Fax: 662-349-3263 | |
Shadell Cater, RDMS,RVT Radiology Medicare: Not Enrolled in Medicare Practice Location: 7165 Swinnea Rd Bldg B2, Southaven, MS 38671 Phone: 662-612-4658 |