| 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 |