| Dr Teofilo Gozaine, MD | |
|
830 Pennsylvania Ave Ste 204, Charleston, WV 25302-3389 | |
| (304) 388-2980 | |
| Not Available |
| Full Name | Dr Teofilo Gozaine |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Experience | 27 Years |
| Location | 830 Pennsylvania Ave Ste 204, Charleston, West Virginia |
| 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 |
|---|---|---|---|
| 1598764102 | NPI | - | NPPES |
| 1461334 | Medicaid | LA | |
| 1598764102 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | 35888 (West Virginia) | Primary |
| 207Y00000X | Otolaryngology | 15440R (Louisiana) | Secondary |
| 207Y00000X | Otolaryngology | 80003 (Minnesota) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Essentia Health Duluth | Duluth, MN | Hospital |
| Byrd Regional Hospital | Leesville, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Byrd Medical Clinic Inc | 2860460508 | 10 |
| Glen D. Hurlston, M.d., Apmc | 3779557541 | 28 |
| The Duluth Clinic Ltd | 2567374283 | 957 |
| Entity Name | Glen D. Hurlston, M.d., Apmc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306913488 PECOS PAC ID: 3779557541 Enrollment ID: O20040826000006 |
| Entity Name | Byrd Medical Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801895495 PECOS PAC ID: 2860460508 Enrollment ID: O20040921000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Teofilo Gozaine, MD 506 S 6th St, Leesville, LA 71446-4482 Ph: (337) 239-2234 | Dr Teofilo Gozaine, MD 830 Pennsylvania Ave Ste 204, Charleston, WV 25302-3389 Ph: (304) 388-2980 |
Dr. Richard Austin Wallace, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 1306 Kanawha Blvd E, Charleston, WV 25301 Phone: 304-343-4371 Fax: 304-353-0215 | |
Carrie Marie Bush, M.D. Otolaryngology Medicare: Medicare Enrolled Practice Location: 830 Pennsylvania Ave, Suite 405, Charleston, WV 25302 Phone: 304-388-2980 Fax: 304-388-2981 | |
Marcus Doddridge Shaffer, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 830 Pennsylvania Ave, Suite 302, Charleston, WV 25302 Phone: 304-388-2950 Fax: 304-388-2951 | |
Mr. Phillip Todd Nichols, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 500 Donnally St, Suite 200, Charleston, WV 25301 Phone: 304-342-0124 Fax: 304-340-2204 | |
Dr. David Richard Lough, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 500 Donnally St Ste 200, Charleston, WV 25301 Phone: 304-767-7830 Fax: 304-767-7829 | |
Mr. Michael R Goins, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1311 Virginia St. E, Suite 200, Charleston, WV 25301 Phone: 304-353-0200 Fax: 304-353-0337 |