| John A Declue, DO | |
|
2181 Orange Ave E, Tallahassee, FL 32311-6144 | |
| (850) 878-0191 | |
| Not Available |
| Full Name | John A Declue |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 2181 Orange Ave E, Tallahassee, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235104886 | NPI | - | NPPES |
| 1235104886 | Medicaid | MO | |
| 124920003 | Other | MO | MEDICARE PTAN |
| 00571326F | Medicaid | GA | |
| 480095 | Other | GA | BLUECROSSBLUESHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 037522 (Georgia) | Secondary |
| 207Q00000X | Family Medicine | 2014010401 (Missouri) | Primary |
| Entity Name | Capital Region Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477980837 PECOS PAC ID: 4688573686 Enrollment ID: O20070323000507 |
| Mailing Address | Practice Location Address |
|---|---|
| John A Declue, DO 121 Carson Ct, Bainbridge, GA 39819-2700 Ph: (706) 464-2539 | John A Declue, DO 2181 Orange Ave E, Tallahassee, FL 32311-6144 Ph: (850) 878-0191 |
Lucille T Saha, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1723 Mahan Center Blvd, Tallahassee, FL 32308 Phone: 850-878-5310 Fax: 850-878-4483 | |
Stewart Drew Warren, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1301 Hodges Dr, Tallahassee, FL 32308 Phone: 850-431-5741 Fax: 850-431-6403 | |
Dr. Christopher W Delisle, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 960 Learning Way, Tallahassee, FL 32306 Phone: 850-644-6230 Fax: 850-644-4251 | |
Dr. Leslie S Emhof, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1525 Killearn Center Blvd, Tallahassee, FL 32309 Phone: 850-893-6706 Fax: 850-893-2846 | |
Victoria Roy Bates, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1491 Governors Square Blvd, Tallahassee, FL 32301 Phone: 850-383-3300 Fax: 850-523-7490 | |
Holly Klopfenstein, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1301 Hodges Dr, Tallahassee, FL 32308 Phone: 850-431-5714 Fax: 850-431-6403 | |
Moritz Eduard Dehler, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2140 Centerville Pl, Tallahassee, FL 32308 Phone: 850-383-3300 Fax: 850-383-3497 |