Dr Samrajya Lk Gogineni, MD | |
1390 Us Highway 19 S, Leesburg, GA 31763-4831 | |
(229) 312-7490 | |
(229) 312-7495 |
Full Name | Dr Samrajya Lk Gogineni |
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Gender | Female |
Speciality | Internal Medicine |
Location | 1390 Us Highway 19 S, Leesburg, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1306932983 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | 025160 (Georgia) | Primary |
Entity Name | Phoebe Physician Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487899464 PECOS PAC ID: 8426112350 Enrollment ID: O20090121000583 |
Mailing Address | Practice Location Address |
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Dr Samrajya Lk Gogineni, MD Po Box 84009, Columbus, GA 31908-4009 Ph: (229) 312-5800 | Dr Samrajya Lk Gogineni, MD 1390 Us Highway 19 S, Leesburg, GA 31763-4831 Ph: (229) 312-7490 |
Nicole Tahira Perrotte, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 235 Walnut Street, Leesburg, GA 31763 Phone: 229-759-6508 Fax: 229-759-9950 | |
James Hotz, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 235 Walnut Ave S, Leesburg, GA 31763 Phone: 229-759-6508 Fax: 229-759-9950 | |
Deirdre Mae Clairewen Lawson, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 235 Walnut Street, Leesburg, GA 31763 Phone: 229-759-6508 Fax: 229-759-9950 | |
John Edward Vance, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 235 Walnut Ave S, Leesburg, GA 31763 Phone: 229-759-6508 |