| William Dyrk Halstead, MD | |
|
1801 N Jackson St, Tullahoma, TN 37388-2201 | |
| (931) 393-3000 | |
| Not Available |
| Full Name | William Dyrk Halstead |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 44 Years |
| Location | 1801 N Jackson St, Tullahoma, Tennessee |
| 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 |
|---|---|---|---|
| 1912953688 | NPI | - | NPPES |
| P00254188 | Other | TN | MEDICARE RAILROAD |
| 3002115 | Medicaid | TN | |
| 4039161 | Other | TN | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 14889 (Tennessee) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Iris Medical Group | 0648653360 | 82 |
| Entity Name | Southeastern Emergency Physicians LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050125000997 |
| Entity Name | Doctors Urgent Care LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184944407 PECOS PAC ID: 1658496799 Enrollment ID: O20100914000313 |
| Entity Name | Iris Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851025902 PECOS PAC ID: 0648653360 Enrollment ID: O20220812002453 |
| Mailing Address | Practice Location Address |
|---|---|
| William Dyrk Halstead, MD Po Box 634706, Cincinnati, OH 45263-0001 Ph: Not Available | William Dyrk Halstead, MD 1801 N Jackson St, Tullahoma, TN 37388-2201 Ph: (931) 393-3000 |
Robert D Doty Jr., MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1801 N Jackson St, Tullahoma, TN 37388 Phone: 931-393-3000 |
Donald V Tucker, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 William Northern Blvd, Tullahoma, TN 37388 Phone: 931-454-0492 |