| Andrew L Hamby, MD | |
|
706 Turtle Creek Dr, Tyler, TX 75701-1833 | |
| (903) 595-3942 | |
| Not Available |
| Full Name | Andrew L Hamby |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 706 Turtle Creek Dr, Tyler, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760412209 | NPI | - | NPPES |
| 181341 | Other | MO | ANTHEM |
| 215364001 | Medicaid | AR | |
| 200014340A | Medicaid | OK | |
| 100643070A | Medicaid | KS | |
| 209083005 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | E-9583 (Arkansas) | Secondary |
| 208000000X | Pediatrics | 2003020131 (Missouri) | Secondary |
| 208000000X | Pediatrics | V0415 (Texas) | Primary |
| Entity Name | Northwest Benton County Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871553073 PECOS PAC ID: 3577503689 Enrollment ID: O20050509000505 |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew L Hamby, MD #1 Children's Way, Slot 844, Acmg, Little Rock, AR 72202-3500 Ph: (501) 364-2090 | Andrew L Hamby, MD 706 Turtle Creek Dr, Tyler, TX 75701-1833 Ph: (903) 595-3942 |
Krystal Castle, DO Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 305 W Rusk St, Tyler, TX 75701 Phone: 903-592-7304 | |
Daniel Jun Park, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 706 Turtle Creek Dr, Tyler, TX 75701 Phone: 903-595-3942 | |
Mrs. Valerie B Smith, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1350 E Richards St, Tyler, TX 75702 Phone: 903-531-9455 Fax: 903-526-3118 | |
Ms. Yanique Tavia Ellis, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2900 North Broadway Ave, Tyler, TX 75702 Phone: 903-593-1892 | |
Kristina Orey Mitchell, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 E 5th St Ste 100, Tyler, TX 75701 Phone: 903-596-3862 Fax: 903-590-5005 | |
Adelina G. Meadows, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 706 Turtle Creek Dr, Tyler, TX 75701 Phone: 903-595-3942 | |
Dr. Michael David Austin, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 E 5th St, Tyler, TX 75701 Phone: 903-594-2450 Fax: 903-939-0610 |