Beverly L. Waddleton (NPI# 1629004684, PAC ID# 9830002294) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1629004684 |
| PAC ID by PECOS | 9830002294 |
| Professional Enrollment ID | I20050504000914 |
| Full Name | Beverly L. Waddleton |
| Organization Legal Name | ETMC PHYSICIAN GROUP, INC. |
| Address |
117 N Winnsboro St Ut Health East Texas Physicians Quitman TX 75783-2144 |
| Phone Number | 9037636220 |
| Gender | F |
| Credential | MD |
| Graduation Year | 1981 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 4486915600 |
| Number of Group Practice Members | 206 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 451380 | EAST TEXAS MEDICAL CENTER QUITMAN |
| 450083 | EAST TEXAS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 801 N Waldrip, Ut Health E Tx Quitman Hospital, Grand Saline, TX 75140-1024 | 9039627551 | QUITMAN HOSPITAL LLC |
| 117 N Winnsboro St, Ut Health East Texas Physicians, Quitman, TX 75783-2144 | 9037636220 | ETMC PHYSICIAN GROUP, INC. |
| 117 N Winnsboro St, Ut Health E Tx Quitman Hospital, Quitman, TX 75783-2144 | 9037636220 | QUITMAN HOSPITAL LLC |
| Organization Legal Name | ETMC PHYSICIAN GROUP, INC. |
| Physicians | 178 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Varalaxmi Nannaka | Pulmonary Disease | Etmc Physician Group, Inc. | 305 Cottage Rd, Carthage, TX 75633-1511 |
| Betsy Jill Chappell | Nurse Practitioner | Etmc Physician Group, Inc. | 406 E Hwy 243, Canton, TX 75103-2409 |
| Andrea Corine Cooley | Cardiac Surgery | Etmc Physician Group, Inc. | 1000 E 5th St, Suite 400, Tyler, TX 75701-3362 |
| Jason S Murry | General Surgery | Etmc Physician Group, Inc. | 1020 E Idel St, Ut Health East Texas Physicians, Tyler, TX 75701-2024 |
| Ronald J Pinkenburg | Ophthalmology | Etmc Physician Group, Inc. | 16911 Village Lake Dr, Lindale, TX 75771-5065 |
| Francine Fraser Mccain | Obstetrics/gynecology | Etmc Physician Group, Inc. | 1336 S Palestine St, Athens, TX 75751-3621 |
| Lori Fuquay | Nurse Practitioner | Etmc Physician Group, Inc. | 601 Hwy 110 N, Suite O, Whitehouse, TX 75791-3037 |
| Michael Jason Chastant | Nurse Practitioner | Etmc Physician Group, Inc. | 2608 Mcdonald Rd, Tyler, TX 75701-5934 |
| Joseph Leonard Decarlo | Urology | Etmc Physician Group, Inc. | 911 S Beckham Ave, Tyler, TX 75701-1907 |
| Eric D Reed | Otolaryngology | Etmc Physician Group, Inc. | 301 W 19th St, Mt Pleasant, TX 75455-2322 |
| Street Address |
117 N WINNSBORO ST UT HEALTH EAST TEXAS PHYSICIANS |
| City | QUITMAN |
| State | TX |
| Zip | 75783-2144 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Paul D Driver | Emergency Medicine | Tanager Emergency Physicians Pllc | 117 N Winnsboro St, Ut Health Quitman, Quitman, TX 75783-2144 |
| David W Buller | Family Medicine | Tanager Emergency Physicians Pllc | 117 N Winnsboro St, Ut Health Quitman, Quitman, TX 75783-2144 |
| George V Cathey Jr. | Family Medicine | Quitman Hospital LLC | 117 N Winnsboro St, Ut Health E Tx Quitman Hospital, Quitman, TX 75783-2144 |
| Greta Parks-herndon | Emergency Medicine | Tanager Emergency Physicians Pllc | 117 N Winnsboro St, Ut Health Quitman, Quitman, TX 75783-2144 |
| John Charles Royse | Family Medicine | Tanager Emergency Physicians Pllc | 117 N Winnsboro St, Ut Health Quitman, Quitman, TX 75783-2144 |
| Jason B Johnson | Nurse Practitioner | Etmc Physician Group, Inc. | 117 N Winnsboro St, Ut Health East Texas Physicians, Quitman, TX 75783-2144 |
| Michael Dean Knapp | Nurse Practitioner | Texas Em I Medical Services Pa | 117 N Winnsboro St, Quitman, TX 75783-2144 |
| Aderemi Wahid Adewuyi | Internal Medicine | Tanager Emergency Physicians Pllc | 117 N Winnsboro St, Ut Health Quitman, Quitman, TX 75783-2144 |
| Cassie Laine Hampton | Nurse Practitioner | Quitman Hospital LLC | 117 N Winnsboro St, Ut Health E Tx Quitman Hospital, Quitman, TX 75783-2144 |
| Peni J Russell | Nurse Practitioner | Texas Em I Medical Services Pa | 117 N Winnsboro St, Quitman, TX 75783-2144 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy D Cosgrove | Family Practice | Etmc Physician Group, Inc. | 117 N Winnsboro St, Ut Health East Texas Physicians, Quitman, TX 75783-2144 |
| John Derek Wisdom | Chiropractic | Quitman Health Services Pllc | 606 E Goode St, Suite 400, Quitman, TX 75783-2563 |
| Joanne E Wisdom | Chiropractic | Quitman Health Services Pllc | 606 E Goode St, Suite 400, Quitman, TX 75783-2563 |
| Melody Marie Swinford | Family Medicine | Family Care Center Quitman | 606 E Goode St, Suite 100, Quitman, TX 75783-2566 |
| Scott J Olson | Family Medicine | Family Care Center Quitman | 606 E Goode St, Suite 100, Quitman, TX 75783-2566 |
| Gregory Milam Singleton | Clinical Social Worker | 606 E Goode St, Suite 100, Quitman, TX 75783-2566 |
| City | QUITMAN |
| Zip Code | 75783 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | QUITMAN + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Beverly L. Waddleton.
| 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.