| Jerry Deane Tankersley, DMD | |
|
800 Ohio Ave, Clarksdale, MS 38614-7200 | |
| (662) 624-4292 | |
| (662) 627-3629 |
| Full Name | Jerry Deane Tankersley |
|---|---|
| Gender | Male |
| Speciality | Dentist |
| Location | 800 Ohio Ave, Clarksdale, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710111034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2300-86 (Mississippi) | Primary |
| Entity Name | North Sunflower Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891705133 PECOS PAC ID: 7618932294 Enrollment ID: O20041123000318 |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry Deane Tankersley, DMD 510 Highway 322, Clarksdale, MS 38614-4717 Ph: (662) 624-2504 | Jerry Deane Tankersley, DMD 800 Ohio Ave, Clarksdale, MS 38614-7200 Ph: (662) 624-4292 |
Dr. Ralph Joseph Landry, DDD Dentist Medicare: Medicare Enrolled Practice Location: 512 1st St, Clarksdale, MS 38614 Phone: 662-624-8114 | |
Dr. William F Wilson Jr., DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 850 Desoto Ave, Extended, Clarksdale, MS 38614 Phone: 662-627-1181 Fax: 662-627-3674 | |
Dr. Matthew Joe Chow, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 705 S Choctaw St, Clarksdale, MS 38614 Phone: 662-627-7324 Fax: 662-627-7758 | |
Dr. Grady Devar Watt, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 600 Ohio Ave, Clarksdale, MS 38614 Phone: 662-624-4292 | |
Joseph K Shleweet, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 526 S Choctaw St, Suite B & C, Clarksdale, MS 38614 Phone: 662-627-3633 Fax: 662-627-5655 | |
Dr. Robert Earl Long Sr., DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 527 Desoto Ave, Clarksdale, MS 38614 Phone: 662-627-2565 Fax: 662-627-2524 | |
Dr. Malcolm Douglas Bailey, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 130 Lee Dr, Clarksdale, MS 38614 Phone: 662-627-4791 Fax: 662-627-4791 |