| Lydia Ann Fusetti, MD | |
|
1835 Nw Kings Blvd, Corvallis, OR 97330 | |
| (541) 753-3542 | |
| (541) 752-0952 |
| Full Name | Lydia Ann Fusetti |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1835 Nw Kings Blvd, Corvallis, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871508374 | NPI | - | NPPES |
| 268359 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | MD12443 (Oregon) | Primary |
| Entity Name | Good Samaritan Hospital Corvallis |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962453134 PECOS PAC ID: 1557270725 Enrollment ID: O20031125000163 |
| Entity Name | Albany General Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154372340 PECOS PAC ID: 9931097987 Enrollment ID: O20040310000310 |
| Entity Name | University Professional Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376709535 PECOS PAC ID: 4880760107 Enrollment ID: O20080910000013 |
| Mailing Address | Practice Location Address |
|---|---|
| Lydia Ann Fusetti, MD 1835 Nw Kings Blvd, Corvallis, OR 97330 Ph: (541) 753-3542 | Lydia Ann Fusetti, MD 1835 Nw Kings Blvd, Corvallis, OR 97330 Ph: (541) 753-3542 |
Dr. Destiny Jennifer Gmelch, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3600 Nw Samaritan Dr, Corvallis, OR 97330 Phone: 541-768-5111 | |
Chinh T. Le, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 530 Nw 27th St, Corvallis, OR 97330 Phone: 541-766-6835 | |
Elizabeth Ranae Davis, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 3680 Nw Samaritan Dr, Corvallis, OR 97330 Phone: 541-754-1150 | |
Wayne Joseph Merback, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3600 Nw Samaritan Dr, Corvallis, OR 97330 Phone: 541-768-5111 | |
Dr. Lon Mcquillan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 777 Nw 9th St, Suite 320, Corvallis, OR 97330 Phone: 541-768-4900 | |
Ms. Kathryn I Mcquillan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3680 Nw Samaritan Dr, Corvallis, OR 97330 Phone: 541-754-1150 | |
Jill A Miller, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3680 Nw Samaritan Dr, Corvallis, OR 97330 Phone: 541-754-1150 |