Dr Stephen Jewell Hansard, | |
606 S Greenwood St, Lagrange, GA 30240-3128 | |
(706) 882-5551 | |
(706) 812-8558 |
Full Name | Dr Stephen Jewell Hansard |
---|---|
Gender | Male |
Speciality | Dentist |
Location | 606 S Greenwood St, Lagrange, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467493130 | NPI | - | NPPES |
000422463D | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | DN010845 (Georgia) | Primary |
Entity Name | Good Samaritan Health Center Of Cobb |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881923126 PECOS PAC ID: 7214970482 Enrollment ID: O20050608000595 |
Mailing Address | Practice Location Address |
---|---|
Dr Stephen Jewell Hansard, 606 S Greenwood St, P O Box 2030, Lagrange, GA 30240-3128 Ph: (706) 882-5551 | Dr Stephen Jewell Hansard, 606 S Greenwood St, Lagrange, GA 30240-3128 Ph: (706) 882-5551 |
Dr. John Bowen Beall, DMD Dentist Medicare: Medicare Enrolled Practice Location: 106 Corporate Plaza Dr, Lagrange, GA 30241 Phone: 706-882-2597 Fax: 706-882-0836 | |
Angela Bulloch-patterson, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 202 Calumet Center Rd, Lagrange, GA 30241 Phone: 706-298-0007 Fax: 706-298-5008 | |
Robert S Gold, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 104 Harwell Ave, Lagrange, GA 30240 Phone: 706-837-0123 Fax: 706-884-2649 | |
Dr. Joel William Pritchett, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 307 Church St, Lagrange, GA 30240 Phone: 706-882-0591 Fax: 706-845-9546 | |
Dr. George W Childress, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 114 Calumet Center Rd, Lagrange, GA 30241 Phone: 706-882-1888 Fax: 706-882-0321 | |
Deema Raslan, Dentist Medicare: Not Enrolled in Medicare Practice Location: 307 Church St, Lagrange, GA 30240 Phone: 706-884-3263 | |
Dr. David Keith Fagundes, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 105 Parker Dr, Suite A, Lagrange, GA 30240 Phone: 706-884-3636 Fax: 706-884-8490 |