Jason Gordon, MD | |
3950 Austell Rd, Austell, GA 30106-1121 | |
(770) 732-3800 | |
Not Available |
Full Name | Jason Gordon |
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Gender | Male |
Speciality | Emergency Medicine |
Location | 3950 Austell Rd, Austell, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720245160 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207P00000X | Emergency Medicine | PENDING (Georgia) | Primary |
Entity Name | The Bortolazzo Group, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801965082 PECOS PAC ID: 3476554320 Enrollment ID: O20070122000015 |
Entity Name | Atlantic Cod Emergency Physicians Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801292693 PECOS PAC ID: 0345567616 Enrollment ID: O20150325001463 |
Mailing Address | Practice Location Address |
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Jason Gordon, MD 5665 New Northside Dr Nw, Suite 320, Atlanta, GA 30328-5831 Ph: (770) 874-5400 | Jason Gordon, MD 3950 Austell Rd, Austell, GA 30106-1121 Ph: (770) 732-3800 |
Michelle Presley, Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3950 Austell Rd, Austell, GA 30106 Phone: 770-732-4000 | |
Dr. Zachary Richard Wetendorf, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3950 Austell Rd, Austell, GA 30106 Phone: 770-732-3886 Fax: 770-732-7280 | |
Dr. Mark P Cruz, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3950 Austell Rd, Austell, GA 30106 Phone: 770-732-4000 | |
Dr. Craig S Brummer, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3950 Austell Rd, Austell, GA 30106 Phone: 770-732-4000 | |
Bradley Stearns, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3950 Austell Rd, Austell, GA 30106 Phone: 770-732-4000 | |
Kirsten Haskelle Bendeck, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3950 Austell Road, Emergency Department, Austell, GA 30328 Phone: 770-732-4000 | |
Gerald Bortolazzo, Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 3950 Austell Rd, Austell, GA 30106 Phone: 770-732-4000 |