Wallace Clements Tarry, MD | |
146 Medical Park Rd, Ste 206, Mooresville, NC 28117-8528 | |
(704) 799-3939 | |
Not Available |
Full Name | Wallace Clements Tarry |
---|---|
Gender | Male |
Speciality | Vascular Surgery |
Experience | 35 Years |
Location | 146 Medical Park Rd, Mooresville, North Carolina |
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 |
---|---|---|---|
1205804945 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 200200613 (North Carolina) | Secondary |
2086S0129X | Surgery - Vascular Surgery | 200200613 (North Carolina) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Carolinas Medical Center-northeast | Concord, NC | Hospital |
Lake Norman Regional Medical Center | Mooresville, NC | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Carolinas Physicians Network Inc | 3375449655 | 1649 |
Entity Name | Carolinas Physicians Network Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477878890 PECOS PAC ID: 3375449655 Enrollment ID: O20031219000455 |
Mailing Address | Practice Location Address |
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Wallace Clements Tarry, MD Po Box 19305, Charlotte, NC 28219-9305 Ph: () - | Wallace Clements Tarry, MD 146 Medical Park Rd, Ste 206, Mooresville, NC 28117-8528 Ph: (704) 799-3939 |
Francis Michael Campbell, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 123 Professional Park Dr, Suite 101, Mooresville, NC 28117 Phone: 704-663-7905 Fax: 704-360-4954 | |
Michelle Marie Bertsch, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 131 Medical Park Rd Ste 306, Mooresville, NC 28117 Phone: 704-660-2610 Fax: 704-660-2611 | |
Timothy Ryan Heider, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 106 Alexander Bank Dr Ste 300, Mooresville, NC 28117 Phone: 704-660-4584 Fax: 704-660-4967 | |
Dr. Matthew Jeffrey Johnson Jr., MD Surgery Medicare: Medicare Enrolled Practice Location: 229 Medical Park Rd Ste 300, Mooresville, NC 28117 Phone: 704-360-9995 Fax: 704-360-2221 | |
Brendan M Marr, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 131 Medical Park Rd Ste 303, Mooresville, NC 28117 Phone: 704-660-4584 Fax: 704-660-4967 | |
Dr. Creighton D Fiscina, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 106 Alexander Bank Dr Ste 300, Mooresville, NC 28117 Phone: 704-660-4584 Fax: 704-660-4967 |