| Miss Lori Louise Martin, PAC | |
|
576 Jefferson Ave, Primary Care Clinic Rm 330, Fort Eustis, VA 23604-1602 | |
| (757) 314-7613 | |
| Not Available |
| Full Name | Miss Lori Louise Martin |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 26 Years |
| Location | 576 Jefferson Ave, Fort Eustis, Virginia |
| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538159298 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | PA15787 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| California Wound Healing Medical Group Inc. | 7315033198 | 21 |
| Entity Name | Healthcare Partners Affiliates Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659312593 PECOS PAC ID: 7315842002 Enrollment ID: O20031204001258 |
| Entity Name | California Wound Healing Medical Group Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235333972 PECOS PAC ID: 7315033198 Enrollment ID: O20071010000465 |
| Entity Name | Harbor Comprehensive Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093000606 PECOS PAC ID: 3971775479 Enrollment ID: O20111005000427 |
| Entity Name | Minghsun Liu MD PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518309368 PECOS PAC ID: 6608004775 Enrollment ID: O20140117000335 |
| Entity Name | May MD Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467037382 PECOS PAC ID: 4486054574 Enrollment ID: O20210610002758 |
| Entity Name | Healing Edge Medical Group - Ca |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982432506 PECOS PAC ID: 2062951635 Enrollment ID: O20240827002556 |
| Entity Name | Vitality Ageless Center LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730657271 PECOS PAC ID: 6800135872 Enrollment ID: O20240920001696 |
| Entity Name | Integrated Wound Care and Support Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285520296 PECOS PAC ID: 9032619101 Enrollment ID: O20250822002824 |
| Mailing Address | Practice Location Address |
|---|---|
| Miss Lori Louise Martin, PAC 797 S Fair Oaks Ave, Pasadena, CA 91105-2617 Ph: (310) 621-6439 | Miss Lori Louise Martin, PAC 576 Jefferson Ave, Primary Care Clinic Rm 330, Fort Eustis, VA 23604-1602 Ph: (757) 314-7613 |
Mr. Sean Donohue, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 576 Jefferson Ave, Fort Eustis, VA 23604 Phone: 760-979-6685 |
Mr. Reed Maurice Jordan, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 127 Jefferson Ave, Mcdonald Army Health Center, Fort Eustis, VA 23604 Phone: 757-314-7500 |
Mrs. Gail A. Evans, PHYSICIAN ASSISTANT Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 210 Dillon Circle, Dcg-imt Coe, Fort Eustis, VA 23604 Phone: 912-429-7762 |
Mr. Herbert Wayne Smiley, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 576 Jefferson Ave, Fort Eustis, VA 23604 Phone: 757-314-7602 |
Mr. Nathaniel L Hill, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 576 Jefferson Ave, Mcdonald Army Hospital, Fort Eustis, VA 23604 Phone: 757-878-1688 |
Benjamin Steven Ingerson, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 576 Jefferson Ave, Fort Eustis, VA 23604 Phone: 757-314-7500 Fax: 757-314-7953 |
Mr. Clifton Trinidad, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 576 Jefferson Ave, Mcdonald Army Health Center, Fort Eustis, VA 23604 Phone: 757-314-7522 |