| Disney Kulachati Samutsakorn, PA-C | |
|
2817 Rock Merritt Ave, Fort Bragg, NC 28310-4504 | |
| (910) 907-8922 | |
| (910) 907-6069 |
| Full Name | Disney Kulachati Samutsakorn |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 3 Years |
| Location | 2817 Rock Merritt Ave, Fort Bragg, North Carolina |
| 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 |
|---|---|---|---|
| 1255875571 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 0010-14417 (North Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Cape Fear Valley Medical Center | Fayetteville, NC | Hospital |
| Columbus Regional Healthcare System | Whiteville, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cfv Express Care Billing Services Llc | 1456353960 | 20 |
| Cumberland County Hospital System Inc | 1850204041 | 581 |
| Entity Name | Cumberland County Hospital System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881946242 PECOS PAC ID: 1850204041 Enrollment ID: O20031112000693 |
| Entity Name | Cfv Express Care Billing Services LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396842514 PECOS PAC ID: 1456353960 Enrollment ID: O20070213000650 |
| Entity Name | Columbus Emergency Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588813786 PECOS PAC ID: 2961560446 Enrollment ID: O20081028000380 |
| Mailing Address | Practice Location Address |
|---|---|
| Disney Kulachati Samutsakorn, PA-C Po Box 40908, Fayetteville, NC 28309-0908 Ph: (910) 615-6949 | Disney Kulachati Samutsakorn, PA-C 2817 Rock Merritt Ave, Fort Bragg, NC 28310-4504 Ph: (910) 907-8922 |
Bonnie Claire-kamei Barkley, PA-S Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2817 Rock Merritt Ave, Fort Bragg, NC 28310 Phone: 910-907-8922 Fax: 910-907-6069 |
Mr. Brent Francis Bachman, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 2817 Reilly Street, Fort Bragg, NC 28310 Phone: 910-907-8617 |
Johnathan Hoggatt, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2817 Rock Merritt Ave, Fort Bragg, NC 28310 Phone: 910-907-8922 |
Mr. Thomas Jones Matherly, PA C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2817 Reilly Road, Womack Army Medical Center Dooh Pes Meb, Fort Bragg, NC 28310 Phone: 910-907-8602 Fax: 910-907-8602 |
Chelsea Joanna Mccully, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2817 Rock Merritt Ave, Fort Bragg, NC 28310 Phone: 910-907-8922 Fax: 910-907-6069 |
Thad J Dabback, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2817 Rock Merritt Ave, Fort Bragg, NC 28310 Phone: 910-907-8707 |
Mr. Kurt Hammermueller, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2817 Reilly Rd, Wamcak Army Medical Center, Fort Bragg, NC 28310 Phone: 910-951-4393 Fax: 910-907-4222 |