| Thomas John Wall, MD | |
|
200 College Dr, Blackwood, NJ 08012-3228 | |
| (856) 536-1630 | |
| Not Available |
| Full Name | Thomas John Wall |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 9 Years |
| Location | 200 College Dr, Blackwood, New Jersey |
| 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 |
|---|---|---|---|
| 1952822595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MA10804200 (New Jersey) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Cooper University Hospital | Camden, NJ | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cooper Family Medicine Pc | 4284530197 | 98 |
| Entity Name | Cooper Physician Offices Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154369510 PECOS PAC ID: 2860396611 Enrollment ID: O20031122000067 |
| Entity Name | Camcare Health Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790857696 PECOS PAC ID: 2567365117 Enrollment ID: O20040130000243 |
| Entity Name | Cooper Family Medicine Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649217175 PECOS PAC ID: 4284530197 Enrollment ID: O20080417000457 |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas John Wall, MD 1 Federal St # 200, Camden, NJ 08103-1088 Ph: (856) 356-4924 | Thomas John Wall, MD 200 College Dr, Blackwood, NJ 08012-3228 Ph: (856) 536-1630 |
Suresh C Doshi, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 59 Spring Lane Dr, Blackwood, NJ 08012 Phone: 856-228-0545 | |
Lois R Halleck, NURSE PRACTITIONER Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 141 S Black Horse Pike, Suite 104, Blackwood, NJ 08012 Phone: 856-292-8216 Fax: 856-848-3011 | |
Dr. Frank Milton Banks, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 744 Erial Rd, Blackwood, NJ 08012 Phone: 856-228-3641 Fax: 856-228-4906 | |
Dr. Gintare T Gecys, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1504 Blackwood Clementon Rd, Blackwood, NJ 08012 Phone: 856-228-0144 Fax: 856-232-0320 |