| Gautam C Thakur, MD | |
|
751 Liberty St, Meadville, PA 16335-2559 | |
| (814) 333-5144 | |
| (814) 373-2255 |
| Full Name | Gautam C Thakur |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 751 Liberty St, Meadville, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578502167 | NPI | - | NPPES |
| 0016368510004 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | MD061648L (Pennsylvania) | Primary |
| Entity Name | Scranton Quincy Clinic Company Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508143074 PECOS PAC ID: 0143487389 Enrollment ID: O20120131000544 |
| Mailing Address | Practice Location Address |
|---|---|
| Gautam C Thakur, MD Po Box 1420, Clearfield, PA 16830-5420 Ph: (877) 235-7686 | Gautam C Thakur, MD 751 Liberty St, Meadville, PA 16335-2559 Ph: (814) 333-5144 |
Frederic Thomas Mcdermott, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 751 Liberty St, Meadville, PA 16335 Phone: 814-333-5145 Fax: 814-333-5197 | |
Dr. Brian J. Karlovits, D.O. Radiology Medicare: Accepting Medicare Assignments Practice Location: 18201 Conneaut Lake Rd, Meadville, PA 16335 Phone: 814-373-2335 Fax: 814-373-2338 | |
Dr. Michael O'malley, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 751 Liberty St, Meadville, PA 16335 Phone: 814-333-5144 Fax: 814-373-2255 | |
Eric W Svenson, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 16792 Conneaut Lake Rd, Meadville, PA 16335 Phone: 814-373-2335 Fax: 814-373-2338 |