| Mancel Wayne Wakham, DO | |
|
2497 S. Roane St., Suite 110, Harriman, TN 37748 | |
| (865) 230-5698 | |
| Not Available |
| Full Name | Mancel Wayne Wakham |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 2497 S. Roane St., Harriman, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073568218 | NPI | - | NPPES |
| 0140287 | Other | UNITED HEALTHCARE | |
| P00114578 | Other | MEDICARE TRAVELERS | |
| Q036092 | Medicaid | TN | |
| TN0101 | Other | JOHN DEERE HEALTHCARE | |
| 4091772 | Other | TN | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 982 (Tennessee) | Primary |
| Entity Name | Abode Care Partners Ltc Vb, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972372225 PECOS PAC ID: 8325316516 Enrollment ID: O20240129001302 |
| Entity Name | Abode Care Partners Al Vb Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518736834 PECOS PAC ID: 1658403704 Enrollment ID: O20240201000465 |
| Entity Name | Mancel Wakham Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487475067 PECOS PAC ID: 9830627439 Enrollment ID: O20250109003965 |
| Mailing Address | Practice Location Address |
|---|---|
| Mancel Wayne Wakham, DO 2497 S. Roane St., Suite 110, Harriman, TN 37748 Ph: (865) 230-5698 | Mancel Wayne Wakham, DO 2497 S. Roane St., Suite 110, Harriman, TN 37748 Ph: (865) 230-5698 |
Rodney Moore Mcmillin, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 408 N Roane St, Harriman, TN 37748 Phone: 865-882-3745 Fax: 865-882-6072 | |
Jennifer Stevens, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1855 Tanner Way Ste 200, Harriman, TN 37748 Phone: 865-376-6272 Fax: 865-374-2100 | |
Spenser Wolken, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8045 Roane Medical Center Dr, Harriman, TN 37748 Phone: 865-316-1000 | |
Joshua David Clark-fuqua, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1855 Tanner Way Ste 200, Harriman, TN 37748 Phone: 865-376-6272 Fax: 864-560-1565 | |
Dr. Steven Alan Crews, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2305 N Gateway Ave Unit 2, Harriman, TN 37748 Phone: 658-822-0108 Fax: 865-882-0099 | |
Miriam B Tedder, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 525a Devonia St, Harriman, TN 37748 Phone: 865-882-5701 Fax: 865-882-2568 |