Ted W Weatherred, MD | |
1120 15th St, Room 2144, Augusta, GA 30912-0004 | |
(706) 721-3873 | |
(706) 721-7763 |
Full Name | Ted W Weatherred |
---|---|
Gender | Male |
Speciality | Anesthesiology |
Location | 1120 15th 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 |
---|---|---|---|
1063583763 | NPI | - | NPPES |
550789920 | Other | GA | TRICARE |
339267 | Other | GA | WELLCARE CMO |
480929 | Other | GA | BCBS |
050031131 | Other | GA | RRMEDICARE |
000542165B | Medicaid | GA | |
000542165C | Medicaid | GA | |
G34979 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 034979 (Georgia) | Primary |
Entity Name | Au Medical Associates Anesthesia Billing Services, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801843933 PECOS PAC ID: 1557256393 Enrollment ID: O20040219000488 |
Entity Name | Wellstar Medical Group, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
Mailing Address | Practice Location Address |
---|---|
Ted W Weatherred, MD Po Box 28068, Chattanooga, TN 37424-8068 Ph: (877) 899-1033 | Ted W Weatherred, MD 1120 15th St, Room 2144, Augusta, GA 30912-0004 Ph: (706) 721-3873 |
Rosa Maria Lopez Rincon, Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-446-5836 | |
Yulia Kungurova, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1120 15th St # Bi-2183, Augusta, GA 30912 Phone: 706-721-0180 | |
Richard E. Lynch, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 804 Scott Nixon Memorial Dr, Attn: Provider Enrollment, Augusta, GA 30907 Phone: 800-394-4445 Fax: 706-955-0735 | |
Dr. Edward Kurt Leahy, Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1 Freedom Way, Augusta, GA 30904 Phone: 706-733-0188 | |
Dr. Marshall D. Bedder, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3813 | |
Dr. John William Whiteley, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3873 Fax: 706-721-7763 | |
Sami Mohammad Hafsa, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3871 |