| Dr Gerald Thomas Russell, MD | |
|
11130 Kingston Pike, Suite 7&8, Farragut, TN 37934-2865 | |
| (865) 675-1953 | |
| Not Available |
| Full Name | Dr Gerald Thomas Russell |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 11130 Kingston Pike, Farragut, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043200603 | NPI | - | NPPES |
| 31906521 | Medicaid | TN | |
| 3706633 | Other | TN | MEDICARE GROUP |
| 3706633 | Other | TN | MEDICAID GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD0000012638 (Tennessee) | Primary |
| Entity Name | Summit Medical Group, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659090298 PECOS PAC ID: 2860396330 Enrollment ID: O20031125000793 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gerald Thomas Russell, MD 1225 E Weisgarber Rd, Suite 200, Knoxville, TN 37909-2604 Ph: (865) 584-4747 | Dr Gerald Thomas Russell, MD 11130 Kingston Pike, Suite 7&8, Farragut, TN 37934-2865 Ph: (865) 675-1953 |
James Kevin Buchanan, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 11130 Kingston Pike, Suite 7&8, Farragut, TN 37934 Phone: 865-675-1953 | |
John Lynn Law, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 11130 Kingston Pike, Suite 7&8, Farragut, TN 37934 Phone: 865-675-1953 | |
Welborn David England, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 11130 Kingston Pike, Suite 7&8, Farragut, TN 37934 Phone: 865-675-1953 | |
Dr. Richard W Mattison, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 11130 Kingston Pike Ste 7&8, Farragut, TN 37934 Phone: 865-675-1953 Fax: 865-675-0877 |