Gregory Taylor Ellison, | |
1430 Harper St, Building B, Augusta, GA 30901-0617 | |
(706) 724-5451 | |
(706) 724-9562 |
Full Name | Gregory Taylor Ellison |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 1430 Harper St, Augusta, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780678516 | NPI | - | NPPES |
G24806 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 024806 (Georgia) | Primary |
Entity Name | Augusta Surgical Group, P.c. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275626038 PECOS PAC ID: 9931488251 Enrollment ID: O20161109001040 |
Mailing Address | Practice Location Address |
---|---|
Gregory Taylor Ellison, 1430 Harper St, Building B, Augusta, GA 30901-0617 Ph: (706) 724-5451 | Gregory Taylor Ellison, 1430 Harper St, Building B, Augusta, GA 30901-0617 Ph: (706) 724-5451 |
Dr. Erika Simmerman Mabes, D.O. Surgery Medicare: Medicare Enrolled Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3052 Fax: 706-721-7501 | |
Dr. Elizabeth D Fox, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-8623 Fax: 706-721-1459 | |
Mary Kathryn Boggs, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3647 J Dewey Gray Cir Ste 200, Augusta, GA 30909 Phone: 706-504-9712 Fax: 706-504-9703 | |
Dr. James Raley, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-2503 Fax: 706-721-1047 | |
Dr. Kathryne Holmes, MD Surgery Medicare: Medicare Enrolled Practice Location: 1120 15th St Rm Bi4076, Augusta, GA 30912 Phone: 706-721-4651 | |
Mr. Keith F. O'malley, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3671 | |
Dr. Thuy-huong Thi Pham, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1120 15th St, Bl 4070, Augusta, GA 30912 Phone: 706-721-0000 Fax: 706-721-1047 |