| Dr Judson Daniell Rackley, MD | |
|
200 Johnson Ridge Medical Park, Elkin, NC 28621-2443 | |
| (336) 526-0040 | |
| Not Available |
| Full Name | Dr Judson Daniell Rackley |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 25 Years |
| Location | 200 Johnson Ridge Medical Park, Elkin, North Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578583829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 2018-02609 (North Carolina) | Primary |
| 208800000X | Urology | ME0095219 (Florida) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Hugh Chatham Memorial Hospital | Elkin, NC | Hospital |
| Novant Health Forsyth Medical Center | Winston-salem, NC | Hospital |
| North Carolina Baptist Hospital | Winston-salem, NC | Hospital |
| Alleghany County Memorial Hospital | Sparta, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Piedmont Stone Center Pllc | 2961315718 | 71 |
| Hugh Chatham Memorial Hospital Inc | 2062311442 | 76 |
| Entity Name | Piedmont Stone Center Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700827409 PECOS PAC ID: 2961315718 Enrollment ID: O20031107000688 |
| Entity Name | Hugh Chatham Memorial Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447373063 PECOS PAC ID: 2062311442 Enrollment ID: O20040717000340 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Judson Daniell Rackley, MD 360 Parkwood Medical Park, Elkin, NC 28621-2444 Ph: () - | Dr Judson Daniell Rackley, MD 200 Johnson Ridge Medical Park, Elkin, NC 28621-2443 Ph: (336) 526-0040 |
Dominick John Carbone Jr., MD Urology Medicare: Accepting Medicare Assignments Practice Location: 200 Johnson Ridge Medical Park, Elkin, NC 28621 Phone: 336-526-0040 Fax: 336-526-0043 |