| Lea Marlys Mackinnon, | |
|
2301 Erwin Road, Durham, NC 27710-3052 | |
| (919) 684-2711 | |
| Not Available |
| Full Name | Lea Marlys Mackinnon |
|---|---|
| Gender | Female |
| Speciality | Diagnostic Radiology |
| Experience | 10 Years |
| Location | 2301 Erwin Road, Durham, North Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699154542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | R75042 (Arizona) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 2020-00318 (North Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| St Luke's Wood River Medical Center | Ketchum, ID | Hospital |
| St Luke's Nampa Medical Center | Nampa, ID | Hospital |
| St Luke's Elmore Medical Center | Mountain home, ID | Hospital |
| Saint Alphonsus Regional Medical Center | Boise, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Boise Radiology Group Pllc | 9638153257 | 55 |
| Entity Name | Boise Radiology Group Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740216175 PECOS PAC ID: 9638153257 Enrollment ID: O20040614000277 |
| Entity Name | Weiser Valley Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255364030 PECOS PAC ID: 5294704276 Enrollment ID: O20050124000126 |
| Entity Name | North Canyon Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609046671 PECOS PAC ID: 0941371439 Enrollment ID: O20090409000304 |
| Mailing Address | Practice Location Address |
|---|---|
| Lea Marlys Mackinnon, Po Box 63362, Charlotte, NC 28263-3362 Ph: () - | Lea Marlys Mackinnon, 2301 Erwin Road, Durham, NC 27710-3052 Ph: (919) 684-2711 |
Mary Margaret Woodruff, Radiology Medicare: Accepting Medicare Assignments Practice Location: 2301 Erwin Rd, Durham, NC 27705 Phone: 919-684-6111 | |
Dr. Roger L Cothran Jr., M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 4101 N Roxboro St, Durham, NC 27704 Phone: 919-684-8111 | |
Zachary Angel, Radiology Medicare: Medicare Enrolled Practice Location: 2301 Erwin Rd, Durham, NC 27705 Phone: 919-684-8111 | |
Reginald R Pareja, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3022 Croasdaile Dr Ste 101, Durham, NC 27705 Phone: 877-780-5559 | |
Mamata Myneni, Radiology Medicare: Accepting Medicare Assignments Practice Location: 2100 Erwin Rd, Banner Good Samaritan Medical Center, Durham, NC 27705 Phone: 919-684-8111 | |
Dr. Matthew Jacob Boyer, M.D., PH.D. Radiology Medicare: Medicare Enrolled Practice Location: Durham Vamc Department Of Radiation Oncology, 508 Fulton St, Durham, NC 27705 Phone: 919-286-6996 | |
Hersh Rajesh Patel, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: Duke University Medical Center, Durham, NC 27710 Phone: 919-684-2711 |