| Dr Alise Magnuson, MD | |
|
146 S Main St, Lexington, VA 24450-2356 | |
| (540) 462-6270 | |
| (540) 319-5172 |
| Full Name | Dr Alise Magnuson |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 146 S Main St, Lexington, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508864638 | NPI | - | NPPES |
| 098235 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 0101233351 (Virginia) | Primary |
| 208000000X | Pediatrics | 63116 (Arizona) | Secondary |
| Entity Name | Carilion Healthcare Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447206370 PECOS PAC ID: 5890607253 Enrollment ID: O20031106000273 |
| Entity Name | Carilion Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730123472 PECOS PAC ID: 9830096585 Enrollment ID: O20040107000472 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Alise Magnuson, MD 213 S Jefferson St Ste 1006, Roanoke, VA 24011-1713 Ph: Not Available | Dr Alise Magnuson, MD 146 S Main St, Lexington, VA 24450-2356 Ph: (540) 462-6270 |
Linh Thi Tran, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 25 Northridge Ln, Lexington, VA 24450 Phone: 540-464-8700 |
James M. Kennedy Jr., MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 25 Northridge Ln, Lexington, VA 24450 Phone: 540-464-8700 |
Dr. Percita Loren Ellis, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 6 Grouse Run Rd, Lexington, VA 24450 Phone: 540-463-1006 Fax: 540-463-2003 |