| Mabbu Gajapathy Shivaprasad, MD | |
|
Logan Family Medical Center Llc, 2210 Timber Trail, Bellefontaine, OH 43311 | |
| (937) 593-3151 | |
| (937) 593-5438 |
| Full Name | Mabbu Gajapathy Shivaprasad |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 42 Years |
| Location | Logan Family Medical Center Llc, Bellefontaine, Ohio |
| 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 |
|---|---|---|---|
| 1083795850 | NPI | - | NPPES |
| 2017373 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35-072257 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Care At Home By Green Hills Llc | Bellefontaine, OH | Home health agency |
| Mary Rutan Hospital | Bellefontaine, OH | Hospital |
| Memorial Hospital | Marysville, OH | Hospital |
| Entity Name | Logan Family Medical Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285824979 PECOS PAC ID: 7517865272 Enrollment ID: O20031219000616 |
| Entity Name | Cedar Ridge Behavioral Health Solutions Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063779460 PECOS PAC ID: 5698927432 Enrollment ID: O20170509000856 |
| Mailing Address | Practice Location Address |
|---|---|
| Mabbu Gajapathy Shivaprasad, MD 2210 Timber Trail, Bellefontaine, OH 43311 Ph: (937) 593-3151 | Mabbu Gajapathy Shivaprasad, MD Logan Family Medical Center Llc, 2210 Timber Trail, Bellefontaine, OH 43311 Ph: (937) 593-3151 |
Dr. Deron L Horman, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1134 N Main St Ste 1100, Bellefontaine, OH 43311 Phone: 937-651-6820 Fax: 937-651-6822 | |
Michael Richey Gleason, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 212 E Columbus Ave Ste 3, Bellefontaine, OH 43311 Phone: 937-592-8025 | |
Thomas E. Darrah, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 130 N Detroit St, Bellefontaine, OH 43311 Phone: 937-599-3085 | |
Dr. Kristen Theobald Braig, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2211 Timber Trl, Maple Leaf Family And Sports Medicine, Bellefontaine, OH 43311 Phone: 937-592-3808 Fax: 937-593-8404 | |
Mrs. Mona Kaye Garrison, FNP-C Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1860 S Main St, Bellefontaine, OH 43311 Phone: 937-592-0731 | |
Steven Paul Hooley, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 705 N Madriver St, Bellefontaine, OH 43311 Phone: 937-592-2248 Fax: 937-592-5001 |