Raymond L Fuller Jr. (NPI# 1639374408, PAC ID# 7517870629) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1639374408 |
| PAC ID by PECOS | 7517870629 |
| Professional Enrollment ID | I20031112000273 |
| Full Name | Raymond L Fuller Jr. |
| Organization Legal Name | BLUEGRASS INTERNAL MEDICINE ASSOCIATES PC |
| Address |
353 New Shackle Island Rd Suite 245 C Hendersonville TN 37075-9999 |
| Phone Number | 6158262265 |
| Gender | M |
| Credential | DO |
| Medical School | PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 1972 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 6800709916 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440194 | TRISTAR HENDERSONVILLE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 353 New Shackle Island Rd, Suite 245 C, Hendersonville, TN 37075-9999 | 6158262265 | BLUEGRASS INTERNAL MEDICINE ASSOCIATES PC |
| Organization Legal Name | BLUEGRASS INTERNAL MEDICINE ASSOCIATES PC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Abigail J Eubank | Nurse Practitioner | Bluegrass Internal Medicine Associates PC | 353 New Shackle Island Rd, Suite 245 C, Hendersonville, TN 37075-9999 |
| Street Address |
353 NEW SHACKLE ISLAND RD SUITE 245 C |
| City | HENDERSONVILLE |
| State | TN |
| Zip | 37075-9999 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marc Tressler | Orthopedic Surgery | Premier Orthopaedics and Sports Medicine Plc | 353 New Shackle Island Rd, Suite 141c, Hendersonville, TN 37075-2366 |
| Gary Wayne Yawn Jr. | Cardiovascular Disease (cardiology) | Centennial Heart LLC | 353 New Shackle Island Rd, Bldg C Suite 300, Handersonville, TN 37075-2329 |
| Jill Steier | Obstetrics/gynecology | Advanced Diagnostic Imaging PC | 353 New Shackle Island Rd, Suite 221b, Hendersonville, TN 37075-2382 |
| Jodi D Gerdes | Vascular Surgery | Advanced Diagnostic Imaging PC | 353 New Shackle Island Rd, Suite 222b, Hendersonville, TN 37075-2369 |
| Jane M Siegel | Hand Surgery | Tennessee Orthopaedic Alliance Pa | 353 New Shackle Island Rd, Suite 148c, Hendersonville, TN 37075-2366 |
| Katherine Stewart | Nurse Practitioner | Centennial Heart LLC | 353 New Shackle Island Rd, Bldg C Suite 300, Handersonville, TN 37075-2329 |
| Jeffrey A Winslow | Occupational Therapy | Tennessee Orthopaedic Alliance Pa | 353 New Shackle Island Rd, Suite 148c, Hendersonville, TN 37075-2366 |
| Lisa Diaz-barriga | Nurse Practitioner | Interventional Pain Center, Pllc | 353 New Shackle Island Rd, Suite 101 A, Hendersonville, TN 37075-2379 |
| William G Davis | General Surgery | Hendersonville Surgeons | 353 New Shackle Island Rd, Suite 102a, Hendersonville, TN 37075-2359 |
| Patrick Wallace Meacham | Vascular Surgery | 353 New Shackle Island Rd, 348c, Hendersonville, TN 37075-2378 | |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Hailu T Kabtimer | Internal Medicine | 919 W Main -, Hendersonville, TN 37075 | |
| Gina Mendoza | Podiatry | Advanced Diagnostic Imaging PC | 353 New Shackle Island, Roasuite 110 A, Hendersonville, TN 37075 |
| Stephanie E Kaelin | Nurse Practitioner | The Little Clinic of Tennessee LLC | 1010 Glenbrook Way, Hendersonville, TN 37075-1230 |
| Kevin Johnson | Optometry | Johnson I-care, LLC | 1024 Glenbrook Way, Hendersonville, TN 37075-1230 |
| Salimah N Jones | Nurse Practitioner | The Little Clinic of Tennessee LLC | 1010 Glenbrook Way, Hendersonville, TN 37075-1230 |
| Brittany Radtke | Nurse Practitioner | The Little Clinic of Tennessee LLC | 1010 Glenbrook Way, Hendersonville, TN 37075-1230 |
| Heather Marie Wood | Nurse Practitioner | The Little Clinic of Tennessee LLC | 1010 Glenbrook Way, Hendersonville, TN 37075-1230 |
| Thomas J Frye | Optometry | Johnson I-care, LLC | 1024 Glenbrook Way, Hendersonville, TN 37075-1230 |
| Mark T Compton | Physician Assistant | Tennessee Family Medicine, Plc | 1047 Glenbrook Way, Suite 120, Hendersonville, TN 37075-1231 |
| Timothy E O Leary | Physician Assistant | Tennessee Family Medicine, Plc | 1047 Glenbrook Way, Suite 120, Hendersonville, TN 37075-1231 |
| Find all physicians in zip 37075 | |||
| City | HENDERSONVILLE |
| Zip Code | 37075 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | HENDERSONVILLE + INTERNAL MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.