Jenna Corinne Coon Fussell, MD | |
1700 Tree Ln Ste 320, Snellville, GA 30078-6747 | |
(770) 972-7999 | |
Not Available |
Full Name | Jenna Corinne Coon Fussell |
---|---|
Gender | Female |
Speciality | Surgery |
Location | 1700 Tree Ln Ste 320, Snellville, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467938084 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 4351035412 (Michigan) | Secondary |
208600000X | Surgery | 96435 (Georgia) | Primary |
208600000X | Surgery | 4301115839 (Michigan) | Secondary |
Entity Name | Piedmont Providers Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548273592 PECOS PAC ID: 9830082825 Enrollment ID: O20040204000321 |
Mailing Address | Practice Location Address |
---|---|
Jenna Corinne Coon Fussell, MD 221 Michign St Ne Ste 402, Grand Rapids, MI 49503-2538 Ph: (616) 391-1405 | Jenna Corinne Coon Fussell, MD 1700 Tree Ln Ste 320, Snellville, GA 30078-6747 Ph: (770) 972-7999 |
Andrew A. Kramer, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1600 Medical Way, Suite 220, Snellville, GA 30078 Phone: 770-972-7999 Fax: 770-972-9528 | |
Dr. Marshall Eli Lutske, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1700 Medical Way, Snellville, GA 30078 Phone: 770-979-0200 | |
Gordon Bradley Werbel, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1800 Tree Lane Rd, Suite 330, Snellville, GA 30078 Phone: 770-978-0561 Fax: 770-978-0546 | |
Dr. Daniel William Maxwell, DO Surgery Medicare: Medicare Enrolled Practice Location: 1700 Tree Ln Ste 320, Snellville, GA 30078 Phone: 770-972-7999 | |
Hisa Yamaguchi, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1600 Medical Way Ste 220, Snellville, GA 30078 Phone: 770-972-7999 Fax: 770-972-9528 | |
Dr. Raquel Camille Jones, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1700 Medical Way, Snellville, GA 30078 Phone: 770-979-0200 |