| Dr Mark W Fugate, MD | |
|
2501 Citico Ave, Chattanooga, TN 37404-1127 | |
| (423) 697-2000 | |
| (423) 697-2320 |
| Full Name | Dr Mark W Fugate |
|---|---|
| Gender | Male |
| Speciality | Vascular Surgery |
| Experience | 23 Years |
| Location | 2501 Citico Ave, Chattanooga, Tennessee |
| 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 |
|---|---|---|---|
| 1124227459 | NPI | - | NPPES |
| P00741318 | Other | RR MEDICARE | |
| 4230402 | Other | TN | BCBS |
| 1515384 | Medicaid | TN | |
| 163534 | Medicaid | AL | |
| 540820812A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | MD44206 (Tennessee) | Secondary |
| 2086S0129X | Surgery - Vascular Surgery | 44206 (Tennessee) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Memorial Healthcare System, Inc | Chattanooga, TN | Hospital |
| Chi Memorial Hospital- Georgia | Fort oglethorpe, GA | Hospital |
| Carolina Pines Regional Medical Center | Hartsville, SC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Memorial Health Partners Foundation, Inc | 8022919570 | 408 |
| Memorial Health Partners Foundation, Inc | 8022919570 | 408 |
| Entity Name | Memorial Health Partners Foundation, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922053545 PECOS PAC ID: 8022919570 Enrollment ID: O20040116000823 |
| Entity Name | Chattanooga Hamilton County Hospital Authority |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154751931 PECOS PAC ID: 0547179731 Enrollment ID: O20040302001086 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark W Fugate, MD 2501 Citico Ave, Chattanooga, TN 37404-1127 Ph: (423) 697-2000 | Dr Mark W Fugate, MD 2501 Citico Ave, Chattanooga, TN 37404-1127 Ph: (423) 697-2000 |
Dr. Julie Ann Koffron, MD Surgery Medicare: Medicare Enrolled Practice Location: 2108 E 3rd St Ste 200, Chattanooga, TN 37404 Phone: 423-267-0466 Fax: 423-778-5177 | |
Dr. Daniel Franklin Fisher Jr., M.D. Surgery Medicare: Medicare Enrolled Practice Location: 2108 E 3rd St, Suite 200, Chattanooga, TN 37404 Phone: 423-267-0466 Fax: 423-778-8212 | |
Gerri Monique Black, PA Surgery Medicare: Not Enrolled in Medicare Practice Location: 721 Glenwood Dr Ste 560, Chattanooga, TN 37404 Phone: 423-622-2494 | |
Dr. Jason Paul Rehm, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 979 E 3rd St, Suite C920, Chattanooga, TN 37403 Phone: 423-756-7134 Fax: 423-763-4571 | |
Dr. Cauley W Hayes, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 979 E 3rd St, Suite C920, Chattanooga, TN 37403 Phone: 423-756-7134 Fax: 423-763-4571 | |
Dr. Benjamin W Dart Iv, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 979 E 3rd St, Ste 300, Chattanooga, TN 37403 Phone: 423-267-0466 Fax: 423-757-0775 | |
Charles T Brice, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 979 E 3rd St, Ste B 801, Chattanooga, TN 37403 Phone: 423-267-2392 Fax: 423-778-2433 |