| Tiffanie D Noonan, DO | |
|
3227 Walter Dr Ste C1, Johns Island, SC 29455-8171 | |
| (843) 920-0046 | |
| (843) 920-0001 |
| Full Name | Tiffanie D Noonan |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 3227 Walter Dr Ste C1, Johns Island, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801830708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | OS9813 (Florida) | Secondary |
| 208000000X | Pediatrics | 83446 (South Carolina) | Primary |
| Entity Name | Healthtap Medical Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518330539 PECOS PAC ID: 2062813827 Enrollment ID: O20210707000244 |
| Mailing Address | Practice Location Address |
|---|---|
| Tiffanie D Noonan, DO Po Box 1661, Johns Island, SC 29457-1661 Ph: (843) 920-0046 | Tiffanie D Noonan, DO 3227 Walter Dr Ste C1, Johns Island, SC 29455-8171 Ph: (843) 920-0046 |
Kelli Elizabeth Johnston, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 3312 Maybank Hwy Ste B, Johns Island, SC 29455 Phone: 843-894-3490 Fax: 833-450-6022 | |
Dr. Margaret Kathleen Roth, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1807 Crowne Commons Way, Johns Island, SC 29455 Phone: 843-203-2280 Fax: 843-203-2281 |