| Hao A Ly, MD | |
|
421 S Main St, Crossville, TN 38555-5048 | |
| (931) 484-9511 | |
| Not Available |
| Full Name | Hao A Ly |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 421 S Main St, Crossville, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861437378 | NPI | - | NPPES |
| 3073524 | Other | TN | BLUE CROSS BLUE SHIELD TN |
| 3812851 | Medicaid | TN | |
| P00231561 | Other | TN | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 29369 (Tennessee) | Secondary |
| 207P00000X | Emergency Medicine | MD450962 (Pennsylvania) | Primary |
| Entity Name | Emergency Coverage Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427005008 PECOS PAC ID: 3072412592 Enrollment ID: O20050207000666 |
| Entity Name | Eagle Creek Emergency Group, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134627557 PECOS PAC ID: 2466714571 Enrollment ID: O20180329000029 |
| Mailing Address | Practice Location Address |
|---|---|
| Hao A Ly, MD 1431 Centerpoint Blvd, Suite 100, Knoxville, TN 37932-1984 Ph: () - | Hao A Ly, MD 421 S Main St, Crossville, TN 38555-5048 Ph: (931) 484-9511 |
William Matthew (matt) Pugh, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 421 S Main St, Crossville, TN 38555 Phone: 931-484-9511 | |
Dr. Chennakesava Reddy Kummathi, M.D Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 421 S Main St, Crossville, TN 38555 Phone: 931-484-9511 |