Courtney L Grant, MD | |
725 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3834 | |
(678) 207-4000 | |
(770) 531-2435 |
Full Name | Courtney L Grant |
---|---|
Gender | Female |
Speciality | Vascular Surgery |
Experience | 11 Years |
Location | 725 Jesse Jewell Pkwy Se, Gainesville, Georgia |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033557459 | NPI | - | NPPES |
003235364G | Medicaid | GA | |
003235364D | Medicaid | GA | |
003235364B | Medicaid | GA | |
003235364C | Medicaid | GA | |
003235364F | Medicaid | GA | |
003235364H | Medicaid | GA | |
003235364A | Medicaid | GA | |
003235364E | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 0116025753 (Virginia) | Secondary |
208600000X | Surgery | 86237 (Georgia) | Secondary |
2086S0129X | Surgery - Vascular Surgery | 86237 (Georgia) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Piedmont Fayette Hospital | Fayetteville, GA | Hospital |
Piedmont Newnan Hospital, Inc | Newnan, GA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Newnan Vascular Center, Llc | 7113043167 | 4 |
Rosenthal, Clark And Matsurra | 8729001938 | 5 |
Entity Name | Rosenthal, Clark And Matsurra |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568670180 PECOS PAC ID: 8729001938 Enrollment ID: O20060112000991 |
Entity Name | Newnan Vascular Center, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1144540519 PECOS PAC ID: 7113043167 Enrollment ID: O20100927001299 |
Mailing Address | Practice Location Address |
---|---|
Courtney L Grant, MD Po Box 742616, Atlanta, GA 30374-2616 Ph: () - | Courtney L Grant, MD 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3834 Ph: (678) 207-4000 |
Dr. Thomas Gregory Delong, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1387 Springdale Rd, Gainesville, GA 30501 Phone: 770-534-0984 | |
Phillip Patrick Rideout, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 200 S Enota Dr Ne Ste 360, Gainesville, GA 30501 Phone: 770-219-4000 | |
Alexis Deana Smith, MD Surgery Medicare: Medicare Enrolled Practice Location: 1439 Jesse Jewell Pkwy Ne Ste 301, Gainesville, GA 30501 Phone: 770-219-9234 | |
Derek Paul Pendarvis, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501 Phone: 770-536-2323 Fax: 770-536-4947 | |
Julius Timothy Fulenwider, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1075 Jesse Jewell Pkwy Ne, Ste B, Gainesville, GA 30501 Phone: 770-536-5733 Fax: 770-534-2114 | |
James A. Butts Jr., MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501 Phone: 770-536-2323 Fax: 770-536-4947 |