| Anthony D Khim, MD | |
|
101 Berrywood Dr, Columbia, TN 38401-6409 | |
| (931) 381-2110 | |
| (931) 381-5178 |
| Full Name | Anthony D Khim |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 40 Years |
| Location | 101 Berrywood Dr, Columbia, Tennessee |
| 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 |
|---|---|---|---|
| 1295736940 | NPI | - | NPPES |
| 3041871 | Other | TN | BLUE CROSS BLUE SHIELD TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 94865 (Georgia) | Secondary |
| 174400000X | Specialist | 867084 (Tennessee) | Primary |
| 208800000X | Urology | C4408 (Kentucky) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Maury Regional Hospital | Columbia, TN | Hospital |
| Marshall Medical Center | Lewisburg, TN | Hospital |
| Southern Tennessee Regional Health System Pulaski | Pulaski, TN | Hospital |
| Cookeville Regional Medical Center | Cookeville, TN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Columbia Urological Associates, P.a. | 1254463334 | 4 |
| Cookeville Regional Medical Group Inc | 8325092638 | 52 |
| Wellstar Medical Group Llc | 6709065402 | 2734 |
| Entity Name | Maury Regional Medical Group, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205886264 PECOS PAC ID: 7911810742 Enrollment ID: O20040227000252 |
| Entity Name | Cookeville Regional Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649202102 PECOS PAC ID: 8325092638 Enrollment ID: O20050309000874 |
| Entity Name | Columbia Urological Associates, P.a. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881809614 PECOS PAC ID: 1254463334 Enrollment ID: O20100726000464 |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony D Khim, MD 101 Berrywood Dr, Columbia, TN 38401-6409 Ph: (615) 599-1647 | Anthony D Khim, MD 101 Berrywood Dr, Columbia, TN 38401-6409 Ph: (931) 381-2110 |