| Blake Thompson, | |
|
1340 S 18th St Ste 204, Fernandina Beach, FL 32034-4733 | |
| (904) 398-7205 | |
| (904) 277-7054 |
| Full Name | Blake Thompson |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Gastroenterology |
| Location | 1340 S 18th St Ste 204, Fernandina Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134624687 | NPI | - | NPPES |
| 122460200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | ME167699 (Florida) | Primary |
| Entity Name | Borland Groover Clinic, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881644912 PECOS PAC ID: 6507761301 Enrollment ID: O20031204000789 |
| Mailing Address | Practice Location Address |
|---|---|
| Blake Thompson, 4800 Belfort Rd, Jacksonville, FL 32256-6004 Ph: (904) 398-3385 | Blake Thompson, 1340 S 18th St Ste 204, Fernandina Beach, FL 32034-4733 Ph: (904) 398-7205 |
Dr. William Fletcher Drewry Jr., MD Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 5483 Florence Point Dr, Fernandina Beach, FL 32034 Phone: 904-415-5097 | |
John Hartwell Houston Mooney, M.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 1348 S 18th St Ste 200, Fernandina Beach, FL 32034 Phone: 904-261-9786 Fax: 904-277-4143 | |
Joseph A Lonzetta Jr., DO Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 1987 S 8th St, Fernandina Beach, FL 32034 Phone: 904-624-7003 | |
Dr. George Glenn Le-bert, D.O. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 1340 S 18th St Ste 202, Credentialing Department, Fernandina Beach, FL 32034 Phone: 904-261-9786 Fax: 904-261-6567 | |
Dr. Andrew Dean Magnet, MD, PHD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 505 Crosswind Dr, Fernandina Beach, FL 32034 Phone: 912-677-7739 | |
Dr. Grant Tyler Whittaker, M.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 1348 South 18th Street, Suite 100, Fernandina Beach, FL 32034 Phone: 904-261-0879 Fax: 904-277-7054 | |
Dr. Harvey Gene Phillips Jr., MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 1348 South 18th Street, Suite 100, Fernandina Beach, FL 32034 Phone: 904-261-0878 Fax: 904-277-7054 |