Lafayette Burks, MD | |
865 S 1st St, Jesup, GA 31545 | |
(904) 805-1300 | |
(904) 805-1302 |
Full Name | Lafayette Burks |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 865 S 1st St, Jesup, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952497760 | NPI | - | NPPES |
945875 | Other | GA | BCBS |
P00270549 | Other | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 50502 (Georgia) | Primary |
Entity Name | Wayne Emergency Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982828943 PECOS PAC ID: 6103926241 Enrollment ID: O20070703000148 |
Entity Name | Erx Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760823082 PECOS PAC ID: 9335037571 Enrollment ID: O20130930000326 |
Entity Name | Southland Optim Jenkins Emergency Medical Services, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265826242 PECOS PAC ID: 9537461538 Enrollment ID: O20160107002680 |
Mailing Address | Practice Location Address |
---|---|
Lafayette Burks, MD Po Box 532855, Atlanta, GA 30353-2855 Ph: (904) 805-1300 | Lafayette Burks, MD 865 S 1st St, Jesup, GA 31545 Ph: (904) 805-1300 |
Mr. Jackson Alexander Harbin, PA-C Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 865 S 1st St, Jesup, GA 31545 Phone: 912-530-3395 | |
Jerry Mullis, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 865 S 1st St, Jesup, GA 31545 Phone: 904-805-1300 Fax: 904-805-1302 |