| Theresa Mae Tilton, MD | |
| 3021 Windermere Road, Lexington, KY 40502-2950 | |
| (859) 278-5270 | |
| (229) 928-3492 | 
| Full Name | Theresa Mae Tilton | 
|---|---|
| Gender | Female | 
| Speciality | Radiology - Diagnostic Radiology | 
| Location | 3021 Windermere Road, Lexington, Kentucky | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1497752588 | NPI | - | NPPES | 
| 300138462 | Other | RR | |
| 488628 | Medicaid | AZ | |
| 808323500 | Medicaid | ID | |
| P00922044 | Other | KY | RXR MEDICARE | 
| 42591 | Other | BCBS | |
| 03083272 | Medicaid | NY | |
| 221123800 | Medicaid | MD | |
| 64927270 | Medicaid | KY | |
| 263513500 | Medicaid | FL | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | ME74267 (Florida) | Secondary | 
| 2085R0202X | Radiology - Diagnostic Radiology | 34103 (Kentucky) | Primary | 
| Entity Name | Donalsonville Hospital Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1720095805 PECOS PAC ID: 7113919820 Enrollment ID: O20040401001194 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Theresa Mae Tilton, MD 23625 Commerce Park, Suite 204, Beachwood, OH 44122-5845 Ph: (216) 255-5727 | Theresa Mae Tilton, MD 3021 Windermere Road, Lexington, KY 40502-2950 Ph: (859) 278-5270 | 
| Dr. Jeremy Wayne Thacker, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 800 Rose St, Hx-302 Ukmc, Lexington, KY 40536 Phone: 859-257-4457 | |
| Dr. Gilroy Lane Daley Sr., M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3111 Maria Drive, Lexington, KY 40516 Phone: 859-293-2429 Fax: 859-293-2429 | |
| Janalyn Prows, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1401 Harrodsburg Rd, Suite A-100, Lexington, KY 40504 Phone: 859-258-6505 Fax: 859-258-6509 | |
| Shailendra Chopra, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1221 S Broadway, Lexington, KY 40504 Phone: 859-258-4181 Fax: 859-258-4058 | |
| Dr. Benedek Joseph Bognar, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 421 Bristol Rd, Lexington, KY 40502 Phone: 859-619-1042 | |
| Barry D Haney, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1218 S Broadway, Suite 310, Lexington, KY 40504 Phone: 859-219-0542 Fax: 859-219-9433 | |
| Dr. Robert Counts Pope, D.O. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1218 S Broadway Ste 310, Lexington, KY 40504 Phone: 859-219-0542 Fax: 859-219-9433 |