| Charles Jonathan Lyerly, DPM | |
|
235 N Broad St, Philadelphia, PA 19107-1531 | |
| (215) 568-3510 | |
| Not Available |
| Full Name | Charles Jonathan Lyerly |
|---|---|
| Gender | Male |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 235 N Broad St, Philadelphia, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104443100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | SC007120 (Pennsylvania) | Primary |
| Provider Name | Gooden Mobile Pod Nc Pllc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1073003752 PECOS PAC ID: 2769738715 Enrollment ID: O20180703003175 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Jonathan Lyerly, DPM 235 N Broad St, Philadelphia, PA 19107-1531 Ph: (215) 568-3510 | Charles Jonathan Lyerly, DPM 235 N Broad St, Philadelphia, PA 19107-1531 Ph: (215) 568-3510 |
Regina Snow, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 5800 Ridge Ave, Philadelphia, PA 19128 Phone: 215-487-4284 | |
Josephine Depalma Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 2706 N 5th St, Philadelphia, PA 19133 Phone: 215-425-5060 Fax: 215-483-9679 | |
Ms. Jennifer Chang - Ching Van, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 148 N 8th St, Philadelphia, PA 19107 Phone: 215-777-5808 Fax: 215-777-5825 | |
Dr. Shaun M Latshaw, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 8835 Germantown Ave, Philadelphia, PA 19118 Phone: 610-428-2427 | |
Dr. Noah Jan Goldman, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 7919 Verree Rd, Philadelphia, PA 19111 Phone: 215-742-8383 | |
Dr. Victoria M. Adeniran, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 5800 Ridge Avenue, Philadelphia, PA 19128 Phone: 215-483-9900 | |
Debbie Park, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 5800 Ridge Ave, Philadelphia, PA 19128 Phone: 215-483-9900 |