| Dr Samantha Dayawansa, MD | |
|
5500 North St, Nacogdoches, TX 75965-1372 | |
| (716) 998-4062 | |
| Not Available |
| Full Name | Dr Samantha Dayawansa |
|---|---|
| Gender | Male |
| Speciality | Neurosurgery |
| Experience | 25 Years |
| Location | 5500 North St, Nacogdoches, Texas |
| 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 |
|---|---|---|---|
| 1376980649 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207T00000X | Neurological Surgery | 95099 (Georgia) | Secondary |
| 207T00000X | Neurological Surgery | V8608 (Texas) | Secondary |
| 207T00000X | Neurological Surgery | 01096248A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Parkview Regional Medical Center | Fort wayne, IN | Hospital |
| Parkview Whitley Hospital | Columbia city, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Archbold Medical Group, Inc. | 8123196383 | 68 |
| Parkview Health System Inc | 2163336967 | 1196 |
| Entity Name | Archbold Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831353036 PECOS PAC ID: 8123196383 Enrollment ID: O20081001000632 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Samantha Dayawansa, MD 5500 North St, Nacogdoches, TX 75965-1372 Ph: (716) 998-4062 | Dr Samantha Dayawansa, MD 5500 North St, Nacogdoches, TX 75965-1372 Ph: (716) 998-4062 |
Neal Gregory Haynes, M.D. Neurological Surgery Medicare: Not Enrolled in Medicare Practice Location: 625 Russell Blvd, Nacogdoches, TX 75965 Phone: 936-560-1190 Fax: 936-560-1823 | |
Dr. James Michael Randle, M.D. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 5500 North St, Nacogdoches, TX 75965 Phone: 936-560-6999 Fax: 936-560-0184 |