Dr Jesse Kenwood Giffhorn, MD | |
1199 Prince Ave, Athens, GA 30606-2797 | |
(706) 475-3665 | |
Not Available |
Full Name | Dr Jesse Kenwood Giffhorn |
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Gender | Male |
Speciality | Pediatrics |
Location | 1199 Prince Ave, Athens, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497014922 | NPI | - | NPPES |
0419629 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208M00000X | Hospitalist | 35.140501 (Ohio) | Secondary |
208000000X | Pediatrics | 94737 (Georgia) | Primary |
208000000X | Pediatrics | 35.140501 (Ohio) | Secondary |
Entity Name | Pediatric Academic Association, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063419943 PECOS PAC ID: 2961306774 Enrollment ID: O20031124000198 |
Mailing Address | Practice Location Address |
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Dr Jesse Kenwood Giffhorn, MD 4881 Sugar Maple Dr, Dayton, OH 45433-5529 Ph: (937) 257-6991 | Dr Jesse Kenwood Giffhorn, MD 1199 Prince Ave, Athens, GA 30606-2797 Ph: (706) 475-3665 |
James Nicholas Frisk, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 125 Telfair Pl, Athens, GA 30606 Phone: 706-548-2454 | |
Victor Morales, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1230 Baxter St, Athens, GA 30606 Phone: 706-389-3000 Fax: 706-389-3839 | |
Charles F Potter, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1230 Baxter St, Athens, GA 30606 Phone: 706-769-0005 | |
Kelly Elizabeth Ordemann, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1199 Prince Ave, Athens, GA 30606 Phone: 504-453-5872 | |
Dr. Ashley Marie Bohn, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1500 Oglethorpe Ave Ste 600ef, Athens, GA 30606 Phone: 706-613-5980 | |
Nancy C Hendrix, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 225 Hawthorne Park, Athens, GA 30606 Phone: 706-613-6136 Fax: 706-353-1604 | |
Pahola Nicolle Rodriguez, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1500 Oglethorpe Ave Ste 600cd, Athens, GA 30606 Phone: 706-559-4188 Fax: 706-559-4177 |