| Michael Lee Stack, MD | |
|
6215 Humphreys Blvd Ste 200, Memphis, TN 38120-2382 | |
| (901) 512-6086 | |
| (833) 450-5323 |
| Full Name | Michael Lee Stack |
|---|---|
| Gender | Male |
| Speciality | Obstetrics/gynecology |
| Experience | 26 Years |
| Location | 6215 Humphreys Blvd Ste 200, Memphis, Tennessee |
| 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 |
|---|---|---|---|
| 1316943301 | NPI | - | NPPES |
| P00475770 | Other | RAILROAD MEDICARE | |
| 4347596 | Other | TN | BCBS |
| 3840616 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 28719 (Tennessee) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Privia Medical Group Tennessee Llc | 0547667552 | 96 |
| Entity Name | Bluff City Obstetrics And Gynecology |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689917759 PECOS PAC ID: 9830336528 Enrollment ID: O20130517000143 |
| Entity Name | Privia Medical Group Tennessee Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376110858 PECOS PAC ID: 0547667552 Enrollment ID: O20210917001131 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Lee Stack, MD 6215 Humphreys Blvd Ste 200, Memphis, TN 38120-2382 Ph: (901) 512-6086 | Michael Lee Stack, MD 6215 Humphreys Blvd Ste 200, Memphis, TN 38120-2382 Ph: (901) 512-6086 |
Kristin M. Miller, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 6750 Poplar Ave, Suite 210, Memphis, TN 38138 Phone: 901-756-6522 Fax: 901-435-0928 | |
Dr. Jason Glenn Williams, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 6745 Wolf River Blvd., Memphis, TN 38120 Phone: 901-767-8442 Fax: 901-684-6260 | |
Dr. Owen P. Phillips, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 6215 Humphreys Blvd Ste 201, Memphis, TN 38120 Phone: 901-866-8085 Fax: 901-515-3429 | |
Claudia Leonard Moise, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 6215 Humphreys Blvd, Suite 401, Memphis, TN 38120 Phone: 901-767-8448 Fax: 901-684-6260 | |
Dr. Kingsley Ogonna Oraedu, MD Obstetrics & Gynecology Medicare: May Accept Medicare Assignments Practice Location: 6027 Walnut Grove Rd Ste 216, Memphis, TN 38120 Phone: 901-274-9717 Fax: 901-684-2008 | |
Mitchell Scott Mcalister, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 2400 Poplar Ave, Suite 501, Memphis, TN 38112 Phone: 901-271-0896 Fax: 901-271-0897 | |
Dr. Dwight Melvyn Moore, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 1264 Wesley Dr, Ste 402, Memphis, TN 38116 Phone: 901-396-5577 Fax: 901-396-5585 |