Kenneth L Tankersley (NPI# 1184607731, PAC ID# 6709043391) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is MAXILLOFACIAL SURGERY.
| Nation Provider ID (NPI) | 1184607731 |
| PAC ID by PECOS | 6709043391 |
| Professional Enrollment ID | I20120209000777 |
| Full Name | Kenneth L Tankersley |
| Organization Legal Name | TDT OMS |
| Address |
716 Denbigh Blvd C1 Hampton Roads Oral and Maxillofacial Newport News VA 23608-4414 |
| Phone Number | 7578746501 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF VIRGINIA COMMONWEALTH UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1997 |
| Primary Specialty | MAXILLOFACIAL SURGERY |
| Secondary Specialties | ORAL SURGERY |
| Group Practice PAC ID | 3476710062 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 901 Enterprise Pkwy, 100 Hampton Roads Oral and Maxillofacial, Hampton, VA 23666-6249 | 7578746501 | TDT OMS |
| 716 Denbigh Blvd, C1 Hampton Roads Oral and Maxillofacial, Newport News, VA 23608-4414 | 7578746501 | TDT OMS |
| Organization Legal Name | TDT OMS |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William L Davenport | Oral Surgery | Tdt Oms | 716 Denbigh Blvd, C1 Hampton Roads Oral and Maxillofacial, Newport News, VA 23608-4414 |
| Maynard Phelps | Maxillofacial Surgery | Tdt Oms | 716 Denbigh Blvd, C1 Hampton Roads Oral and Maxillofacial, Newport News, VA 23608-4414 |
| Street Address |
716 DENBIGH BLVD C1 HAMPTON ROADS ORAL AND MAXILLOFACIAL |
| City | NEWPORT NEWS |
| State | VA |
| Zip | 23608-4414 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William L Davenport | Oral Surgery | Tdt Oms | 716 Denbigh Blvd, C1 Hampton Roads Oral and Maxillofacial, Newport News, VA 23608-4414 |
| Maynard Phelps | Maxillofacial Surgery | Tdt Oms | 716 Denbigh Blvd, C1 Hampton Roads Oral and Maxillofacial, Newport News, VA 23608-4414 |
| Robert C Shwayder | Obstetrics/gynecology | 716 Denbigh Blvd, Suite E2, Newport News, VA 23608-4414 | |
| Daniel W Lee | Family Practice | 716 Denbigh Blvd, Newport News, VA 23608-4414 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leroy Graham Jr. | Family Medicine | 15408 Warwick Blvd, Newport News, VA 23608-1576 | |
| Uzoamaka C Agbasi | Nurse Practitioner | Peninsula Institute for Community Health Inc | 15425 Warwick Blvd, Suite H, Newport News, VA 23608-1579 |
| Michael I Parson | Family Practice | Peninsula Institute for Community Health Inc | 15425 Warwick Blvd, Suite H, Newport News, VA 23608-1579 |
| Kenneth Arndt | Optometry | Zoe Inc. | 422 Oriana Rd, Newport News, VA 23608-3733 |
| Kristy E Ambrose | Optometry | Zoe Inc. | 422 Oriana Rd, Newport News, VA 23608-3733 |
| John D Seago | Optometry | Zoe Inc. | 422 Oriana Rd, Newport News, VA 23608-3733 |
| Jacob D Almeida | Internal Medicine | Tidewater Physicians Multispecialty Group, PC | 555 Denbigh Blvd, Suite C, Newport News, VA 23608-4201 |
| Ashley C Forrest | Physical Therapy | Tidewater Physical Therapy LLC | 612 Denbigh Blvd, Newport News, VA 23608-4416 |
| Le Shante Anise Fairell | Physical Therapy | Tidewater Physical Therapy LLC | 612 Denbigh Blvd, Newport News, VA 23608-4416 |
| Briana Aiken | Physical Therapy | Tidewater Physical Therapy LLC | 612 Denbigh Blvd, Newport News, VA 23608-4416 |
| Find all physicians in zip 23608 | |||
| City | NEWPORT NEWS |
| Zip Code | 23608 |
| Specialty | MAXILLOFACIAL SURGERY |
| City + Specialty | NEWPORT NEWS + MAXILLOFACIAL SURGERY |
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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.