| Mary E Bukovitz, MD | |
|
1817 W Morris Blvd, Morristown, TN 37813-2837 | |
| (423) 581-3904 | |
| (423) 581-6120 |
| Full Name | Mary E Bukovitz |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1817 W Morris Blvd, Morristown, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164517942 | NPI | - | NPPES |
| 3149630 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 6021 (Tennessee) | Primary |
| Entity Name | Summit Medical Group, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659090298 PECOS PAC ID: 2860396330 Enrollment ID: O20031125000793 |
| Mailing Address | Practice Location Address |
|---|---|
| Mary E Bukovitz, MD 1225 E Weisgarber Rd Ste 200, Knoxville, TN 37909-2675 Ph: (865) 584-4747 | Mary E Bukovitz, MD 1817 W Morris Blvd, Morristown, TN 37813-2837 Ph: (423) 581-3904 |
Felistia Nicole Gambill, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1817 W Morris Blvd, Morristown, TN 37813 Phone: 423-581-3904 | |
Renee A Salansky, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1817 W Morris Blvd, Morristown, TN 37813 Phone: 423-581-3904 Fax: 423-581-6120 | |
Dr. Larry Michael Toffoletto, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1817 W Morris Blvd, Morristown, TN 37813 Phone: 423-581-3904 | |
John W Wilkinson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1817 W Morris Blvd, Morristown, TN 37813 Phone: 423-581-3904 Fax: 423-581-6120 | |
Eric G Delay, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 420 W Morris Blvd, Ste. 400g, Morristown, TN 37813 Phone: 423-581-2538 Fax: 423-581-2660 | |
David V Willbanks, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1817 W Morris Blvd, Morristown, TN 37813 Phone: 423-581-3904 Fax: 423-581-6120 |