| Dr Thalia Raya Pachiyannakis, | |
|
1205 Hadley Rd Ste 120, Mooresville, IN 46158-1934 | |
| (317) 834-8950 | |
| (317) 834-8951 |
| Full Name | Dr Thalia Raya Pachiyannakis |
|---|---|
| Gender | Female |
| Speciality | Obstetrics & Gynecology |
| Location | 1205 Hadley Rd Ste 120, Mooresville, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275860314 | NPI | - | NPPES |
| 01072322A | Other | IN | IN LICENSE |
| 1275860314 | Other | IN | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 01072322A (Indiana) | Primary |
| 207V00000X | Obstetrics & Gynecology | 4301094455 (Michigan) | Secondary |
| Entity Name | Heart City Health Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720033418 PECOS PAC ID: 9931008380 Enrollment ID: O20040105000515 |
| Entity Name | The South Bend Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073680419 PECOS PAC ID: 3779577937 Enrollment ID: O20040412000439 |
| Entity Name | Healthlinc Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528262581 PECOS PAC ID: 7618929373 Enrollment ID: O20050210000929 |
| Entity Name | Good Samaritan Hospital Physician Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649432071 PECOS PAC ID: 3971671330 Enrollment ID: O20081013000182 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Thalia Raya Pachiyannakis, Po Box 781076, Detroit, MI 48278-1008 Ph: (317) 528-4800 | Dr Thalia Raya Pachiyannakis, 1205 Hadley Rd Ste 120, Mooresville, IN 46158-1934 Ph: (317) 834-8950 |
Virginia Ann Takagi, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1205 Hadley Rd, Mooresville, IN 46158 Phone: 317-584-3454 Fax: 317-584-3435 | |
Glenn Lee Dobbs, D.O. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 1205 Hadley Rd, Mooresville, IN 46158 Phone: 317-584-3454 Fax: 317-584-3435 | |
James Patrick Perry, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 100 Town Center Rd S, Suite B, Mooresville, IN 46158 Phone: 317-497-2300 Fax: 317-497-2502 | |
Kelli A Hertz, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1205 Hadley Rd Ste 120, Mooresville, IN 46158 Phone: 317-834-8960 Fax: 317-834-8951 | |
Michael Lenwood Boothe, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1205 Hadley Rd, Mooresville, IN 46158 Phone: 317-584-3454 Fax: 317-584-3435 | |
G. Alan Von Stein, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 1205 Hadley Rd, Mooresville, IN 46158 Phone: 317-831-9469 Fax: 317-834-5928 |