MEDICARE: BANGUS SURGICAL SPECIALISTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730886581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BANGUS SURGICAL SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	PO BOX 80333
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19101-1333
Country	:	US
Telephone Number	:	973-251-1132
Fax Number	:

Provider Business Practice Location Address
First Line	:	2175 JENKS AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4551
Country	:	US
Telephone Number	:	407-846-2266
Fax Number	:

Authorized Official
Title or Position	:	OFFICER
Name	:	KAREN VAUGHN
Credential	:
Telephone Number	:	973-251-1132

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	05/19/2023

Similar Medicare Providers

1295714129 — DR. AZZAM A ADHAL MD
Practice Location Address:

2195 JENKS AVE , STE B
PANAMA CITY, FL
32405-4551

Practice Phone: 850-784-6696
Practice Fax: 850-785-2100

1437246089 — BALANCE DIAGNOSTICS LLC
Practice Location Address:

2195 JENKS AVE
PANAMA CITY, FL
32405-4551

Practice Phone: 850-522-4770
Practice Fax: 850-522-4760

1134261225 — YELIU IRISH LMT
Practice Location Address:

2195 JENKS AVE STE A
PANAMA CITY, FL
32405-4551

Practice Phone: 850-747-1444
Practice Fax: 850-747-1444

1124154778 — MRS. GAIL A SOCHACKY-HERBERT
Practice Location Address:

2195 JENKS AVE STE A
PANAMA CITY, FL
32405-4551

Practice Phone: 850-522-4770
Practice Fax: 850-769-2366

1376526566 — DANIEL C YEAGER
Practice Location Address:

2050 KEOKUK ST
IOWA CITY, IA
52240-4551

Practice Phone: 319-337-9724
Practice Fax: 319-337-5445

1184789893 — DR. BERGE MARCARIAN M.D.
Practice Location Address:

4551 W US HIGHWAY 90 , SUITE 101
LAKE CITY, FL
32055-4879

Practice Phone: 386-719-9993
Practice Fax: 386-719-4744

Directions to “BANGUS SURGICAL SPECIALISTS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.