Sonnepal Venkat, MD | |
1080 N Ellington Pkwy, Lewisburg, TN 37091-2227 | |
(904) 805-1300 | |
(904) 805-1302 |
Full Name | Sonnepal Venkat |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 1080 N Ellington Pkwy, Lewisburg, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366489510 | NPI | - | NPPES |
P00051319 | Other | TN | RAILROAD MEDICARE |
4060230 | Other | TN | BLUE CROSS |
3831170 | Medicaid | TN | |
P00051319 | Other | RAILROAD MCR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | MD28089 (Tennessee) | Primary |
Entity Name | Southeastern Emergency Physicians Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050125000997 |
Mailing Address | Practice Location Address |
---|---|
Sonnepal Venkat, MD Po Box 532734, Atlanta, GA 30353-2734 Ph: (904) 805-1300 | Sonnepal Venkat, MD 1080 N Ellington Pkwy, Lewisburg, TN 37091-2227 Ph: (904) 805-1300 |
Gary Swanson, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1080 N Ellington Pkwy, Lewisburg, TN 37091 Phone: 904-805-1300 Fax: 904-805-1302 | |
Charles Galiwango, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1080 N Ellington Pkwy, Lewisburg, TN 37091 Phone: 904-805-1300 Fax: 904-805-1302 | |
Dr. Dennis Mccracken, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 710 Cornersville Rd, Lewisburg, TN 37091 Phone: 931-994-5717 Fax: 931-246-4233 | |
Jim T Harris, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1080 N Ellington Pkwy, Lewisburg, TN 37091 Phone: 931-359-6241 |