| George Michael Lodeiro, MD | |
| 
					460 Medical Park Dr Ste 104, Lenoir City, TN 37772-5782  | |
| (865) 562-3232 | |
| (865) 317-1115 | 
| Full Name | George Michael Lodeiro | 
|---|---|
| Gender | Male | 
| Speciality | Surgery - Vascular Surgery | 
| Location | 460 Medical Park Dr Ste 104, Lenoir City, Tennessee | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1184150930 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | 65808 (Tennessee) | Primary | 
| Entity Name | Innovative Vascular, Pllc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1124750765 PECOS PAC ID: 9335523802 Enrollment ID: O20220901000458  | 
| Entity Name | Apex Vascular Outpatient Center | 
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center | 
| Entity Identifiers | NPI Number: 1467216457 PECOS PAC ID: 1951747922 Enrollment ID: O20240313000316  | 
| Mailing Address | Practice Location Address | 
|---|---|
| George Michael Lodeiro, MD 1924 Alcoa Hwy # U-11, Knoxville, TN 37920-1511 Ph: (865) 305-9230  | George Michael Lodeiro, MD 460 Medical Park Dr Ste 104, Lenoir City, TN 37772-5782 Ph: (865) 562-3232  | 
Wahid John Abadier, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 576 Fort Loudoun Medical Center Dr, Suite 101, Lenoir City, TN 37772 Phone: 865-271-6566 Fax: 865-271-6566  | |
Dr. Benjamin M Pardue, DO Surgery Medicare: Medicare Enrolled Practice Location: 689 Medical Park Dr Ste 101, Lenoir City, TN 37772 Phone: 865-271-6580 Fax: 865-374-1147  | |
Dr. John Henry Eason Jr., MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 460 Medical Park Dr Ste 106, Lenoir City, TN 37772 Phone: 865-988-4452 Fax: 865-988-6293  | |
Dr. David Bernard Staab, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 576 Fort Loudoun Medical Center Dr, #101, Lenoir City, TN 37772 Phone: 865-690-5263  |