William Dyrk Halstead, MD | |
1801 N Jackson St, Tullahoma, TN 37388-2201 | |
(931) 393-3000 | |
Not Available |
Full Name | William Dyrk Halstead |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 1801 N Jackson St, Tullahoma, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912953688 | NPI | - | NPPES |
P00254188 | Other | TN | MEDICARE RAILROAD |
3002115 | Medicaid | TN | |
4039161 | Other | TN | BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 14889 (Tennessee) | Primary |
Entity Name | Southeastern Emergency Physicians Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050125000997 |
Entity Name | Doctors Urgent Care Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1184944407 PECOS PAC ID: 1658496799 Enrollment ID: O20100914000313 |
Mailing Address | Practice Location Address |
---|---|
William Dyrk Halstead, MD Po Box 634706, Cincinnati, OH 45263-0001 Ph: () - | William Dyrk Halstead, MD 1801 N Jackson St, Tullahoma, TN 37388-2201 Ph: (931) 393-3000 |
Robert D Doty Jr., MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1801 N Jackson St, Tullahoma, TN 37388 Phone: 931-393-3000 | |
Donald V Tucker, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 William Northern Blvd, Tullahoma, TN 37388 Phone: 931-454-0492 |