| Dr Thaddeus Ivory Lancaster, MD | |
|
3855 Pleasant Hill Rd Ste 100, Duluth, GA 30096-8030 | |
| (678) 312-7800 | |
| (678) 312-7818 |
| Full Name | Dr Thaddeus Ivory Lancaster |
|---|---|
| Gender | Male |
| Speciality | Obstetrics & Gynecology |
| Location | 3855 Pleasant Hill Rd Ste 100, Duluth, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316904923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 073192 (Maryland) | Secondary |
| 207V00000X | Obstetrics & Gynecology | 73192 (Georgia) | Primary |
| Entity Name | Gwinnett Hospital System, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952340994 PECOS PAC ID: 8123916426 Enrollment ID: O20040309000009 |
| Entity Name | The Southeast Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245266956 PECOS PAC ID: 6204829013 Enrollment ID: O20040407000370 |
| Entity Name | Obhg Georgia, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750686838 PECOS PAC ID: 9032383583 Enrollment ID: O20111117000602 |
| Entity Name | Gwinnett Hospital System Gme, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780076927 PECOS PAC ID: 0648504894 Enrollment ID: O20190622000303 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Thaddeus Ivory Lancaster, MD Po Box 116156, Atlanta, GA 30368-6156 Ph: (470) 325-0100 | Dr Thaddeus Ivory Lancaster, MD 3855 Pleasant Hill Rd Ste 100, Duluth, GA 30096-8030 Ph: (678) 312-7800 |
Kelley Wages Starnes, CNM Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 3650 Steve Reynolds Blvd, Kaiser Permanente Gwinnett Medical Center, Duluth, GA 30096 Phone: 770-931-6110 Fax: 404-252-6794 | |
Dr. Jacqueline Mache Walters, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 3630 Savannah Pl Ste 100, Duluth, GA 30096 Phone: 678-474-0203 Fax: 678-474-0207 | |
Dr. Pearl Gem Hwang, D.O. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 3650 Steve Reynolds Blvd, Kaiser Permanente Gwinnett Medical Center, Duluth, GA 30096 Phone: 770-931-6110 | |
Dr. Vanessa Theresa Rigaud, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 3650 Steve Reynolds Blvd, Duluth, GA 30096 Phone: 404-365-0966 | |
Dr. Andrea Lenore Christian Parks, MD/MBA Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 3650 Steve Reynolds Blvd, Kaiser Permanente Gwinnett Medical Office - Ob/gyn, Duluth, GA 30096 Phone: 770-931-6012 | |
Dr. Jodi-anne Stewart, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 3650 Steve Reynolds Blvd, Duluth, GA 30096 Phone: 770-931-6012 |