| Benjamin Tackett, FNP | |
|
140 Stollings Ave Ste 1, Logan, WV 25601-4035 | |
| (304) 752-2555 | |
| Not Available |
| Full Name | Benjamin Tackett |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 9 Years |
| Location | 140 Stollings Ave Ste 1, Logan, West Virginia |
| 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 |
|---|---|---|---|
| 1265959704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 66717 (West Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Charleston Area Medical Center | Charleston, WV | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Charleston Area Medical Center Inc | 3375441637 | 859 |
| Entity Name | Logan General Hospital Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720032105 PECOS PAC ID: 9537078977 Enrollment ID: O20031217001124 |
| Entity Name | Charleston Area Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124248752 PECOS PAC ID: 3375441637 Enrollment ID: O20031223000426 |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin Tackett, FNP 140 Stollings Ave Ste 1, Logan, WV 25601-4035 Ph: () - | Benjamin Tackett, FNP 140 Stollings Ave Ste 1, Logan, WV 25601-4035 Ph: (304) 752-2555 |
Timothy M Reed, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 20 Hospital Dr, Logan, WV 25601 Phone: 304-831-1188 | |
Mrs. Amber Ellis, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 140 Stollings Ave, Suite 3, Logan, WV 25601 Phone: 304-752-4594 | |
Jenna Marie Hager, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 77 Hospital Dr, Logan, WV 25601 Phone: 304-896-5200 Fax: 304-896-5300 | |
William Ray Watkins Jr., RN, MSN, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 214 Hanging Rock Hwy, Logan, WV 25601 Phone: 304-784-5404 | |
Takara Leeann Muncy, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 174 Lmah Center Rd, Logan, WV 25601 Phone: 304-792-7130 Fax: 304-792-7146 | |
Mr. Printess John Lawrence, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 300 Prosperity Lane, Suite 100, Logan, WV 25601 Phone: 304-831-0073 Fax: 304-831-0471 | |
Patsy Eugenie Stoots, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 20 Hospital Dr, Logan, WV 25601 Phone: 304-831-1101 |