| Dr Ifeanyi Obi Obianyo, MD | |
| 
					353 New Shackle Island Rd, Suite 206 A, Hendersonville, TN 37075-2379  | |
| (615) 264-4743 | |
| (615) 264-4589 | 
| Full Name | Dr Ifeanyi Obi Obianyo | 
|---|---|
| Gender | Male | 
| Speciality | Internal Medicine | 
| Location | 353 New Shackle Island Rd, Hendersonville, Tennessee | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1235171596 | NPI | - | NPPES | 
| 3071527 | Medicaid | TN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | MC18601 (Tennessee) | Primary | 
| 207P00000X | Emergency Medicine | MC18601 (Tennessee) | Secondary | 
| Entity Name | Emergency Medicine Services Of Tn, Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1720785884 PECOS PAC ID: 3173989837 Enrollment ID: O20230523000265  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Ifeanyi Obi Obianyo, MD 353 New Shackle Island Rd, Suite 206 A, Hendersonville, TN 37075-2379 Ph: (615) 264-4743  | Dr Ifeanyi Obi Obianyo, MD 353 New Shackle Island Rd, Suite 206 A, Hendersonville, TN 37075-2379 Ph: (615) 264-4743  | 
Mosunmola Adebowale Ademosu, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 355 New Shackle Island Rd, Hendersonville, TN 37075 Phone: 615-338-1000  | |
Hailu T Kabtimer, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 919 W Main St M3, Hendersonville, TN 37075 Phone: 615-826-2102 Fax: 615-826-2743  | |
Mr. Scott Alan Hande, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 107 Glen Oak Blvd, Suite 202, Hendersonville, TN 37075 Phone: 615-826-0710 Fax: 615-826-0910  | |
Jung H. Lee, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 353 New Shackle Island Rd, #300c, Hendersonville, TN 37075 Phone: 615-338-3337 Fax: 615-338-3329  | |
Dr. Arslan Shaukat, M.B.B.S Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 353 New Shackle Island Rd Ste 300c, Hendersonville, TN 37075 Phone: 615-824-0043 Fax: 615-822-1690  | |
Dr. Marshall R Johnson Jr., MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 355 New Shackle Island Rd, Hendersonville, TN 37075 Phone: 615-338-1000 Fax: 615-338-1101  | |
Paul S Daugherty, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 107 Imperial Blvd, Suite 5, Hendersonville, TN 37075 Phone: 615-826-3111 Fax: 615-826-3112  |