| Thomas Lorenzo Walden Jr, MD | |
|
1200 Pine Run Dr, Lumberton, NC 28358-2180 | |
| (910) 671-5730 | |
| (910) 671-5732 |
| Full Name | Thomas Lorenzo Walden Jr |
|---|---|
| Gender | Male |
| Speciality | Radiology - Radiation Oncology |
| Location | 1200 Pine Run Dr, Lumberton, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447214028 | NPI | - | NPPES |
| 891195L | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | 9800410 (North Carolina) | Primary |
| Entity Name | Southeastern Radiation Oncology |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851355390 PECOS PAC ID: 8426078981 Enrollment ID: O20091021000365 |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas Lorenzo Walden Jr, MD Po Box 41208, Fayetteville, NC 28309-1208 Ph: (910) 609-6691 | Thomas Lorenzo Walden Jr, MD 1200 Pine Run Dr, Lumberton, NC 28358-2180 Ph: (910) 671-5730 |
Dr. Andrew Edward Simays, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 209 West 27th Street, Lumberton, NC 28358 Phone: 910-738-8222 Fax: 910-671-0846 | |
Mack Ira Mcclain, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 209 West 27th Street, Lumberton, NC 28358 Phone: 910-738-8222 Fax: 910-671-0846 | |
Robert J Cherichella, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 304 Grande Oak Blvd W, Suite B, Lumberton, NC 28358 Phone: 910-674-4579 Fax: 910-674-4579 | |
Dr. Thomas David Fisher, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 209 West 27th Street, Lumberton, NC 28358 Phone: 910-738-8222 Fax: 910-671-0846 | |
Jeffrey E. Zapawa, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 300 W 27th St, Lumberton, NC 28358 Phone: 910-671-5000 | |
George Hurst Provosty, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 209 West 27th Street, Lumberton, NC 28358 Phone: 910-738-8222 Fax: 910-671-0846 |