Nicole Tahira Perrotte, MD | |
235 Walnut Street, Leesburg, GA 31763 | |
(229) 759-6508 | |
(229) 759-9950 |
Full Name | Nicole Tahira Perrotte |
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Gender | Female |
Speciality | Internal Medicine |
Location | 235 Walnut Street, 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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1134371446 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 061636 (Georgia) | Primary |
Entity Name | Cogent Healthcare Of Georgia Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609827823 PECOS PAC ID: 2961483607 Enrollment ID: O20040527000856 |
Entity Name | Hospitalist Medicine Physicians Of Georgia - East Point, Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1437637063 PECOS PAC ID: 5294088936 Enrollment ID: O20181029000008 |
Mailing Address | Practice Location Address |
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Nicole Tahira Perrotte, MD 204 N Westover Blvd, Albany, GA 31707-2983 Ph: (229) 888-6559 | Nicole Tahira Perrotte, MD 235 Walnut Street, Leesburg, GA 31763 Ph: (229) 759-6508 |
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 | |
Dr. Samrajya L.k. Gogineni, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 1390 Us Highway 19 S, Leesburg, GA 31763 Phone: 229-312-7490 Fax: 229-312-7495 | |
John Edward Vance, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 235 Walnut Ave S, Leesburg, GA 31763 Phone: 229-759-6508 |