| Tucker Gisler Jennings, MD | |
|
33101 Annapolis St Ste 100, Wayne, MI 48184-2405 | |
| (734) 467-2670 | |
| Not Available |
| Full Name | Tucker Gisler Jennings |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 30 Years |
| Location | 33101 Annapolis St Ste 100, Wayne, Michigan |
| 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 |
|---|---|---|---|
| 1740210251 | NPI | - | NPPES |
| 2258506 | Medicaid | OH | |
| 020049281 | Other | RAILROAD MEDICARE | |
| 3002472000 | Medicaid | WV | |
| 64073851 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 4301506625 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Beaumont Hospital - Wayne | Wayne, MI | Hospital |
| Beaumont Hospital - Grosse Pointe | Grosse pointe, MI | Hospital |
| Beaumont Hospital - Dearborn | Dearborn, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Beaumont Medical Group- Specialty Services | 7214299866 | 804 |
| Entity Name | Beaumont Medical Group- Specialty Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578072906 PECOS PAC ID: 7214299866 Enrollment ID: O20180320002549 |
| Mailing Address | Practice Location Address |
|---|---|
| Tucker Gisler Jennings, MD 26901 Beaumont Blvd, Southfield, MI 48033-3849 Ph: () - | Tucker Gisler Jennings, MD 33101 Annapolis St Ste 100, Wayne, MI 48184-2405 Ph: (734) 467-2670 |
Dr. Vishnu Teja Pemmaraju, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3106 S Wayne Rd, Wayne, MI 48184 Phone: 734-722-6300 Fax: 734-722-4815 | |
Adewunmi Adeyemo, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3106 S Wayne Rd, Wayne, MI 48184 Phone: 734-722-6300 Fax: 734-722-4815 | |
Dr. Dawood Ghassan Dalaly, MS , DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 33155 Annapolis St, Wayne, MI 48184 Phone: 734-467-4000 |