| Tosaporn Krasaeath, MD | |
|
1703 Meadows Ln, Vidalia, GA 30474-8915 | |
| (800) 382-4023 | |
| Not Available |
| Full Name | Tosaporn Krasaeath |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 58 Years |
| Location | 1703 Meadows Ln, Vidalia, Georgia |
| 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 |
|---|---|---|---|
| 1366424640 | NPI | - | NPPES |
| 000292289C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 026884 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Meadows Regional Medical Center | Vidalia, GA | Hospital |
| Appling Hospital | Baxley, GA | Hospital |
| Jeff Davis Hospital | Hazlehurst, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| South Georgia Radiology Associates Llc | 0042389231 | 34 |
| Entity Name | South Georgia Radiology Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760669931 PECOS PAC ID: 0042389231 Enrollment ID: O20080514000110 |
| Mailing Address | Practice Location Address |
|---|---|
| Tosaporn Krasaeath, MD Po Box 2049, Moultrie, GA 31776-2049 Ph: (800) 382-4023 | Tosaporn Krasaeath, MD 1703 Meadows Ln, Vidalia, GA 30474-8915 Ph: (800) 382-4023 |
Henry D Cline, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1 Meadows Pkwy, Vidalia, GA 30474 Phone: 912-538-7777 | |
Anna S Franklin, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1701 Green Acres Dr, Vidalia, GA 30474 Phone: 912-314-0680 | |
Carl Leland Stalvey, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 407 Durden St, Vidalia, GA 30474 Phone: 888-545-5551 |