Otis Mark Hastings, MD | |
14519 Detroit Ave, Lakewood, OH 44107-4316 | |
(216) 521-4200 | |
Not Available |
Full Name | Otis Mark Hastings |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 14519 Detroit Ave, Lakewood, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831146463 | NPI | - | NPPES |
930007405 | Other | OH | MEDICARE TRAVELERS RR-GA |
942460636261 | Other | OH | CARESOURCE |
378646 | Other | OH | WELLCARE |
000000380930 | Other | OH | ANTHEM BC/BS |
0798329 | Medicaid | OH | |
341542312098 | Other | OH | CARESOURCE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 35059241H (Ohio) | Primary |
Entity Name | Emergency Professional Services, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093762353 PECOS PAC ID: 7214832435 Enrollment ID: O20040511000864 |
Mailing Address | Practice Location Address |
---|---|
Otis Mark Hastings, MD 28625 Woodmill Dr, Westlake, OH 44145-2085 Ph: () - | Otis Mark Hastings, MD 14519 Detroit Ave, Lakewood, OH 44107-4316 Ph: (216) 521-4200 |
Steven Carl Blaha, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 14519 Detroit Ave, Lakewood, OH 44107 Phone: 216-521-4200 | |
Charles Richardson Cowap, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 14519 Detroit Ave, Lakewood, OH 44107 Phone: 216-521-4200 | |
Richard Arnold Nelson, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 14519 Detroit Avenue, Lakewood, OH 44107 Phone: 216-521-4200 | |
Brandon John Parker, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 14519 Detroit Ave, Lakewood, OH 44107 Phone: 216-521-4200 | |
Virginia Ann Evans, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 14519 Detroit Ave, Lakewood, OH 44107 Phone: 216-521-4200 |