| Jonathan Glaze, MD | |
|
105 Asbury Cir Ste B, Hattiesburg, MS 39402-1397 | |
| (601) 450-8500 | |
| (601) 450-8501 |
| Full Name | Jonathan Glaze |
|---|---|
| Gender | Male |
| Speciality | Ophthalmology |
| Experience | 7 Years |
| Location | 105 Asbury Cir Ste B, Hattiesburg, Mississippi |
| 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 |
|---|---|---|---|
| 1821551714 | NPI | - | NPPES |
| Q083201 | Medicaid | TN | |
| 200005320 | Medicaid | MS | |
| 305271001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207W00000X | Ophthalmology | 30330 (Mississippi) | Primary |
| 207W00000X | Ophthalmology | 68334 (Tennessee) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hattiesburg Eye Clinic, P.a. | 4587733829 | 12 |
| Entity Name | Hattiesburg Eye Clinic, P.A. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922110949 PECOS PAC ID: 4587733829 Enrollment ID: O20080513000402 |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan Glaze, MD 105 Asbury Cir Ste B, Hattiesburg, MS 39402-1397 Ph: (601) 450-8500 | Jonathan Glaze, MD 105 Asbury Cir Ste B, Hattiesburg, MS 39402-1397 Ph: (601) 450-8500 |
Mr. John Vernon Petro Jr., MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 102 E Hospital Dr, Hattiesburg, MS 39402 Phone: 601-268-5144 Fax: 601-268-5149 |
Julie J Lynn, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-579-5300 Fax: 601-579-5303 |
Christopher L Cooley, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 7148 U S Highway 98, Suite 201, Hattiesburg, MS 39402 Phone: 601-271-2020 Fax: 601-264-2660 |
Sarah Grace Whitehead Sobiesk, Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-579-5300 Fax: 601-579-5302 |
Adam Ellington Quinn, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 100 Hospital Dr W, Hattiesburg, MS 39402 Phone: 601-268-5910 Fax: 601-264-0659 |
Sean C Allison, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 109 Millsaps Dr Ste B, Hattiesburg, MS 39402 Phone: 601-255-0736 |
Cole Mckee Richardson, DO Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 109 Millsaps Dr, Hattiesburg, MS 39402 Phone: 601-818-2957 |