| William P Dutton, MD | |
|
124 Hayes St, Crossville, TN 38555-8005 | |
| (615) 351-1555 | |
| Not Available |
| Full Name | William P Dutton |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Location | 124 Hayes St, Crossville, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861472888 | NPI | - | NPPES |
| 0176490 | Other | TN | BLUE CROSS |
| 340013306 | Other | TN | RR MEDICARE |
| 3150245 | Medicaid | TN | |
| 64745359 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | MD6089 (Tennessee) | Primary |
| Entity Name | Cumberland Physician Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225161227 PECOS PAC ID: 7517059017 Enrollment ID: O20070828000491 |
| Mailing Address | Practice Location Address |
|---|---|
| William P Dutton, MD 49 Cleveland St Ste 230, Crossville, TN 38555-2854 Ph: (931) 459-7012 | William P Dutton, MD 124 Hayes St, Crossville, TN 38555-8005 Ph: (615) 351-1555 |
Dr. Izzuddin Ali Mansur, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 49 Cleveland St, Suite 220, Crossville, TN 38555 Phone: 931-707-8050 Fax: 931-707-8048 | |
Paul Edward Henson Iii, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 49 Cleveland St Ste 350, Crossville, TN 38555 Phone: 931-459-1120 | |
Dr. William M. Young, M.D.. Urology Medicare: Accepting Medicare Assignments Practice Location: 49 Cleveland St Ste 350, Crossville, TN 38555 Phone: 931-459-7720 Fax: 865-374-2113 |