Phanel Basile, MD | |
1800 Combs Rd, Pennington Gap, VA 24277-1808 | |
(276) 546-1440 | |
(865) 291-3228 |
Full Name | Phanel Basile |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 1800 Combs Rd, Pennington Gap, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1750310561 | NPI | - | NPPES |
0125442 | Other | TN | BC BS |
1750310561 | Medicaid | VA | |
P00209168 | Other | VA | RAILROAD MEDICARE |
3050025 | Medicaid | TN | |
64796055 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 0101035989 (Virginia) | Primary |
Entity Name | Emergency Coverage Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427005008 PECOS PAC ID: 3072412592 Enrollment ID: O20050418000414 |
Mailing Address | Practice Location Address |
---|---|
Phanel Basile, MD Po Box 636019, Cincinnati, OH 45263-6019 Ph: () - | Phanel Basile, MD 1800 Combs Rd, Pennington Gap, VA 24277-1808 Ph: (276) 546-1440 |
Stanislav T Merka, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1800 Combs Rd, Pennington Gap, VA 24277 Phone: 276-546-1440 Fax: 865-291-3228 | |
B Allen Kolodziej, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1800 Combs Rd, Pennington Gap, VA 24277 Phone: 276-546-1440 Fax: 865-291-3228 |