| Dr Shannon Altazan, DO | |
|
401 Matthew St, Marietta, OH 45750-1635 | |
| (740) 376-1939 | |
| (740) 374-1693 |
| Full Name | Dr Shannon Altazan |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 401 Matthew St, Marietta, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477057883 | NPI | - | NPPES |
| 0485813 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 34.015793 (Ohio) | Primary |
| 207P00000X | Emergency Medicine | 3742 (West Virginia) | Secondary |
| 207Q00000X | Family Medicine | 34.015793 (Ohio) | Secondary |
| Entity Name | Epmg Of Ohio Inc P A |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841232196 PECOS PAC ID: 1052223799 Enrollment ID: O20031103000158 |
| Entity Name | Selby General Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124073465 PECOS PAC ID: 9638087893 Enrollment ID: O20040108000165 |
| Entity Name | Marietta Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962106328 PECOS PAC ID: 8224928965 Enrollment ID: O20040317000973 |
| Entity Name | Steel Valley Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831145275 PECOS PAC ID: 3577511195 Enrollment ID: O20050110000903 |
| Entity Name | Trinity Hospital Twin City |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992096192 PECOS PAC ID: 6204004534 Enrollment ID: O20111206000207 |
| Entity Name | Columbiana Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336618628 PECOS PAC ID: 9830437508 Enrollment ID: O20190205003349 |
| Entity Name | East Ohio Hospital Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508480930 PECOS PAC ID: 6305260753 Enrollment ID: O20200720000706 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Shannon Altazan, DO 284 Bell Blvd, Weirton, WV 26062-3321 Ph: (225) 802-2197 | Dr Shannon Altazan, DO 401 Matthew St, Marietta, OH 45750-1635 Ph: (740) 376-1939 |
Janelle A Thomas, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 401 Matthew St, Emergency Dept, Marietta, OH 45750 Phone: 740-374-1400 | |
Julian Adam John Jakubowski, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 401 Matthew St, Emergency Department, Marietta, OH 45750 Phone: 740-376-1939 Fax: 740-374-1693 | |
Geoffrey Sirockman, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 401 Matthew St, Emergency Department, Marietta, OH 45750 Phone: 740-568-5669 Fax: 740-568-5279 | |
Conley Diaz-gomez, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 401 Matthew St, Marietta, OH 45750 Phone: 740-376-1939 Fax: 740-374-1693 | |
Terry L Carr, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 401 Matthew St, Emergency Department, Marietta, OH 45750 Phone: 740-376-1939 | |
Dr. Cady Noelle Kennedy, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 401 Matthew Street, Emergency Department, Marietta, OH 45750 Phone: 740-568-5669 | |
Ryan Nagy, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 401 Matthew St, Marietta, OH 45750 Phone: 740-568-5669 |