| Jack F Shamblin Iii, MD | |
|
94 Old Mill Rd, Martinsburg, WV 25401-9284 | |
| (304) 264-8933 | |
| (304) 264-8846 |
| Full Name | Jack F Shamblin Iii |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 36 Years |
| Location | 94 Old Mill Rd, Martinsburg, West Virginia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831159615 | NPI | - | NPPES |
| 0060852000 | Medicaid | WV | |
| 050065778 | Other | WV | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207LP2900X | Anesthesiology - Pain Medicine | 17829 (West Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Berkeley Medical Center | Martinsburg, WV | Hospital |
| Jefferson Medical Center | Ranson, WV | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| City Hospital Inc | 3375444524 | 95 |
| Entity Name | City Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942503164 PECOS PAC ID: 3375444524 Enrollment ID: O20040120000306 |
| Mailing Address | Practice Location Address |
|---|---|
| Jack F Shamblin Iii, MD 94 Old Mill Rd, Martinsburg, WV 25401-9284 Ph: (304) 264-8933 | Jack F Shamblin Iii, MD 94 Old Mill Rd, Martinsburg, WV 25401-9284 Ph: (304) 264-8933 |
Satish Kumar Menon, DO Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 94 Old Mill Rd, Martinsburg, WV 25401 Phone: 304-264-8933 Fax: 304-264-8846 | |
Sarah Mclellan, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 2000 Foundation Way, Suite 3400, Martinsburg, WV 25401 Phone: 304-264-1000 | |
Linda Jones, CRNA Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 94 Old Mill Rd, Martinsburg, WV 25401 Phone: 304-264-8933 Fax: 304-264-8846 | |
Duong Thai Ly, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1006 Tavern Rd, Martinsburg, WV 25401 Phone: 304-267-5141 Fax: 304-267-5140 | |
Paulette Pickett, CRNA Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 94 Old Mill Rd, Martinsburg, WV 25401 Phone: 304-264-8933 Fax: 304-264-8846 | |
Danilo J Gervacio, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 94 Old Mill Rd, Martinsburg, WV 25401 Phone: 304-264-8933 Fax: 304-264-8846 | |
Phillip Nicodemus, CRNA Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 94 Old Mill Rd, Martinsburg, WV 25401 Phone: 304-264-8933 Fax: 304-264-8846 |