Arthur J Provisor, MD | |
1800 10th Ave, Columbus, GA 31901 | |
(706) 571-1120 | |
(706) 660-1603 |
Full Name | Arthur J Provisor |
---|---|
Gender | Male |
Speciality | Pediatrics - Pediatric Hematology-oncology |
Location | 1800 10th Ave, Columbus, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902976152 | NPI | - | NPPES |
00834655B | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0207X | Pediatrics - Pediatric Hematology-oncology | 047358 (Georgia) | Primary |
Entity Name | Mppg Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033131172 PECOS PAC ID: 7012829351 Enrollment ID: O20040223000338 |
Mailing Address | Practice Location Address |
---|---|
Arthur J Provisor, MD 4750 Waters Ave Ste 103, Savannah, GA 31404-6267 Ph: (912) 350-5646 | Arthur J Provisor, MD 1800 10th Ave, Columbus, GA 31901 Ph: (706) 571-1120 |
Subhendu De, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 710 Center St, Columbus, GA 31901 Phone: 706-571-1311 | |
Feoderis N Basilio, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 104 14th St, Columbus, GA 31901 Phone: 706-507-5437 Fax: 706-507-5499 | |
Dr. Barbara Lynn Menchan, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2000 10th Ave, Suite 400, Columbus, GA 31901 Phone: 706-660-2932 Fax: 706-660-2935 | |
Dr. Cheryl Carroll, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2416 Capstone Ct, Columbus, GA 31909 Phone: 706-327-1281 Fax: 706-327-1159 | |
Mrs. Kelli B Whitted, NP Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2001 Brookstone Centre Pkwy, Columbus, GA 31904 Phone: 706-571-9699 Fax: 706-571-9565 | |
Erik A. Heiss, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2416 Capstone Ct, Columbus, GA 31909 Phone: 706-327-1281 Fax: 706-576-9714 | |
David H Levine, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 710 Center St, Columbus, GA 31901 Phone: 706-571-1002 Fax: 706-660-6504 |