| Mr Ellis Tavin, MD | |
|
80 Humphreys Center Dr, #100, Memphis, TN 38120 | |
| (901) 761-9030 | |
| (901) 473-6505 |
| Full Name | Mr Ellis Tavin |
|---|---|
| Gender | Male |
| Speciality | Plastic And Reconstructive Surgery |
| Experience | 38 Years |
| Location | 80 Humphreys Center Dr, 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 |
|---|---|---|---|
| 1326003179 | NPI | - | NPPES |
| 89100200 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208200000X | Plastic Surgery | 9601744 (North Carolina) | Secondary |
| 208200000X | Plastic Surgery | 41308 (Tennessee) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Plastic Surgery Group Of Memphis P.c. | 6608854013 | 6 |
| Entity Name | The Plastic Surgery Group Of Memphis P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831102078 PECOS PAC ID: 6608854013 Enrollment ID: O20040712001171 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Ellis Tavin, MD 8110 N Brother Blvd, Ste 200, Bartlett, TN 38133-2760 Ph: (901) 255-5221 | Mr Ellis Tavin, MD 80 Humphreys Center Dr, #100, Memphis, TN 38120 Ph: (901) 761-9030 |
William Leslie Hickerson, MD Plastic Surgery Medicare: Medicare Enrolled Practice Location: 890 Madison Ave, Suite Tg032, Memphis, TN 38103 Phone: 901-448-2579 Fax: 901-448-2602 | |
Dr. Dani Kruchevsky, MD Plastic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1068 Cresthaven Rd Ste 500, Memphis, TN 38119 Phone: 901-866-8525 Fax: 901-302-2525 | |
Patricia L. Eby, M.D. Plastic Surgery Medicare: Not Enrolled in Medicare Practice Location: 6401 Poplar Ave, Suite 360, Memphis, TN 38119 Phone: 901-752-1412 | |
George Lewis Burruss, M.D. Plastic Surgery Medicare: Medicare Enrolled Practice Location: 80 Humphreys Ctr Ste 100, Memphis, TN 38120 Phone: 901-761-9030 Fax: 901-473-6505 | |
Dr. Sylvia Shepherd Strock, MD Plastic Surgery Medicare: Not Enrolled in Medicare Practice Location: 4634 Peppertree Lane, Memphis, TN 38117 Phone: 901-682-9110 | |
Robert Louis Adams, M.D. Plastic Surgery Medicare: Medicare Enrolled Practice Location: 80 Humphreys Ctr Ste 100, Memphis, TN 38120 Phone: 901-761-9030 Fax: 901-473-6505 | |
Dr. Asghar Koleyni, MD Plastic Surgery Medicare: Not Enrolled in Medicare Practice Location: 6005 Park Avenue, Suite 1007b, Memphis, TN 38119 Phone: 901-761-2400 |