| Mr Luther St James Iii, MD | |
|
1890 Lpga Blvd, 170, Daytona Beach, FL 32117-7130 | |
| (386) 274-3354 | |
| (386) 274-5564 |
| Full Name | Mr Luther St James Iii |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1890 Lpga Blvd, Daytona Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013105477 | NPI | - | NPPES |
| 08883 | Other | FL | BLUE CROSS BLUE SHEILD |
| ME51067 | Other | FL | STATE LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME51067 (Florida) | Primary |
| Entity Name | Memorial Health Systems Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922115914 PECOS PAC ID: 9739081142 Enrollment ID: O20040730000409 |
| Entity Name | Adventhealth Primary Care Network Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093493637 PECOS PAC ID: 1557722410 Enrollment ID: O20230725004134 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Luther St James Iii, MD 1890 Lpga Blvd, 170, Daytona Beach, FL 32117-7130 Ph: (386) 274-3354 | Mr Luther St James Iii, MD 1890 Lpga Blvd, 170, Daytona Beach, FL 32117-7130 Ph: (386) 274-3354 |
Lindsay Marie Podhajsky, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 201 N Clyde Morris Blvd, Daytona Beach, FL 32114 Phone: 386-254-4165 | |
Ejaz Ahmed, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 405 N Clyde Morris Blvd, Daytona Beach, FL 32114 Phone: 386-506-8555 Fax: 386-944-9944 | |
Dr. Margaret Crossman, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 201 North Clyde Morris Blvd., Suite 200, Halifax Family Health Center, Daytona Beach, FL 32114 Phone: 386-947-4665 Fax: 386-258-4891 | |
Dr. Joshua Robert Eisenhut, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 305 Memorial Medical Pkwy Ste 502, Daytona Beach, FL 32117 Phone: 386-231-3570 Fax: 386-231-3571 | |
Kenneth J Lucas, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 405 N Clyde Morris Blvd, 405 N Clyde Morris Blvd, Daytona Beach, FL 32114 Phone: 386-257-1626 Fax: 386-254-7507 | |
Evans Marrero, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 201 N Clyde Morris Blvd Ste 200, Daytona Beach, FL 32114 Phone: 386-425-4165 |