| Dr Charles Vaccaro Menendez Jr, MD | |
|
3109 Bienville Blvd, Ocean Springs, MS 39564-4361 | |
| (228) 762-1353 | |
| Not Available |
| Full Name | Dr Charles Vaccaro Menendez Jr |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 3109 Bienville Blvd, Ocean Springs, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629008974 | NPI | - | NPPES |
| 00117198 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 13597 (Mississippi) | Primary |
| Entity Name | Smb Radiology P A |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609877356 PECOS PAC ID: 9234136060 Enrollment ID: O20061108000496 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Charles Vaccaro Menendez Jr, MD Po Box 2710, Slidell, LA 70459-2710 Ph: (228) 762-1353 | Dr Charles Vaccaro Menendez Jr, MD 3109 Bienville Blvd, Ocean Springs, MS 39564-4361 Ph: (228) 762-1353 |
James Moore Carter, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3109 Bienville Blvd, Ocean Springs, MS 39564 Phone: 228-762-1353 | |
Dr. John Wycoff Godsey, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 502 Martin Ave., Ocean Springs, MS 39564 Phone: 228-875-1392 | |
Brian Twedt, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 202 Rue St Denis, Ocean Springs, MS 39564 Phone: 888-318-8900 | |
Douglas G Cosentino, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3535 Bienville Blvd, Ocean Springs, MS 39564 Phone: 228-818-4201 |