| Martha E Glenn, MD | |
|
6215 Humphreys Blvd, Suite 100, Memphis, TN 38120 | |
| (901) 227-9650 | |
| Not Available |
| Full Name | Martha E Glenn |
|---|---|
| Gender | Female |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 6215 Humphreys Blvd, Memphis, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003922147 | NPI | - | NPPES |
| 300138547 | Other | TN | MEDICARE RR |
| 4053347 | Other | TN | BCBS |
| 98185 | Other | AR | BCBS |
| 3838028 | Medicaid | TN | |
| 05720002 | Medicaid | MS | |
| 149402001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 30861 (Tennessee) | Primary |
| Entity Name | Womens Diagnostic Group Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104922392 PECOS PAC ID: 7113967795 Enrollment ID: O20050504000129 |
| Mailing Address | Practice Location Address |
|---|---|
| Martha E Glenn, MD Po Box 1000, Dept 34 Womens Diagnostic Group Pllc, Memphis, TN 38120 Ph: (901) 383-8860 | Martha E Glenn, MD 6215 Humphreys Blvd, Suite 100, Memphis, TN 38120 Ph: (901) 227-9650 |
Dr. Daniel Wakefield, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 920 Madison Ave, Suite 447, Memphis, TN 38103 Phone: 901-448-5814 | |
Madison H Buckley Jr., MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 50 Humphreys Ctr, Suite 23, Memphis, TN 38120 Phone: 901-226-0810 Fax: 901-383-8985 | |
Paul R Tanner, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 6019 Walnut Grove, Memphis, TN 38120 Phone: 901-383-8860 Fax: 901-383-1194 | |
Matthew T. Ballo, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 100 N Humphreys Blvd, Memphis, TN 38120 Phone: 901-683-0055 Fax: 901-685-2969 | |
Terry L Thompson, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 5959 Park Ave, Radiology Department, Memphis, TN 38119 Phone: 901-765-3212 Fax: 901-765-3212 | |
Stefan J Cowles, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 5959 Park Ave, Radiology Department, Memphis, TN 38119 Phone: 901-765-3212 Fax: 901-765-1727 |