| John R Whitworth, MD | |
|
806 Estate Pl, Memphis, TN 38120-0600 | |
| (901) 681-4017 | |
| (901) 681-4013 |
| Full Name | John R Whitworth |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Pediatric Gastroenterology |
| Location | 806 Estate Pl, Memphis, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699707638 | NPI | - | NPPES |
| 98990 | Other | AR | BLUE CROSS |
| 02724221 | Medicaid | MS | |
| 4128673 | Other | TN | BLUE CROSS |
| 3387689 | Medicaid | TN | |
| H41886 | Other | TN | HEALTHSOURCE |
| 19169 | Medicaid | TN | |
| 4128673 | Medicaid | TN | |
| 185482 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080P0206X | Pediatrics - Pediatric Gastroenterology | 34143 (Tennessee) | Primary |
| Entity Name | Ut Lebonheur Pediatric Specialists, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093024101 PECOS PAC ID: 7719173939 Enrollment ID: O20101130000117 |
| Mailing Address | Practice Location Address |
|---|---|
| John R Whitworth, MD 2670 Union Avenue Ext, Suite 1220, Memphis, TN 38112-4426 Ph: (901) 458-9785 | John R Whitworth, MD 806 Estate Pl, Memphis, TN 38120-0600 Ph: (901) 681-4017 |
Dr. Andrew Buchman Nearn, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2861 Broad Ave, Memphis, TN 38112 Phone: 901-701-2520 Fax: 901-325-6469 | |
Mimily Harsono, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 877 Jefferson Ave, Memphis, TN 38103 Phone: 901-545-7100 | |
Mr. Alberto S. Pappo, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 262 Danny Thomas Pl, Memphis, TN 38105 Phone: 901-595-6765 Fax: 901-521-9005 | |
Edson Ruiz, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 877 Jefferson Ave, Memphis, TN 38103 Phone: 901-448-5950 | |
Dr. Darlene K Cash, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 100 N Humphreys Blvd, Memphis, TN 38120 Phone: 901-322-9080 Fax: 901-322-2994 | |
Dr. Monika Metzger, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 262 Danny Thomas Pl # Ms 515, C/o Dana Cannon, Memphis, TN 38105 Phone: 901-595-3006 Fax: 901-595-3842 | |
Benjamin R Waller Iii, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 51 N Dunlap St Fl 2, Memphis, TN 38105 Phone: 901-287-7337 Fax: 901-287-4646 |