Bryan Shiver, PA | |
2501 N Patterson St, Valdosta, GA 31602-0000 | |
(229) 333-1000 | |
Not Available |
Full Name | Bryan Shiver |
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Gender | Male |
Speciality | Physician Assistant |
Location | 2501 N Patterson St, Valdosta, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538138672 | NPI | - | NPPES |
291857900 | Medicaid | FL | |
856383907B | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363A00000X | Physician Assistant | 003881 (Georgia) | Primary |
Entity Name | Colquitt Regional Emergency Physicians, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902211642 PECOS PAC ID: 6901026509 Enrollment ID: O20141002001293 |
Mailing Address | Practice Location Address |
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Bryan Shiver, PA Po Box 402059, Atlanta, GA 30384-2059 Ph: (229) 333-1000 | Bryan Shiver, PA 2501 N Patterson St, Valdosta, GA 31602-0000 Ph: (229) 333-1000 |
Chaeli Wisenbaker, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 2412 N Oak St, Valdosta, GA 31602 Phone: 229-244-1400 Fax: 229-244-5512 | |
Ashly Mcdaniel, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 3527 N Valdosta Rd, Valdosta, GA 31602 Phone: 229-247-2290 | |
Mr. Lonas Edward Lewis Ii, P.A.-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 3251 Inner Perimeter Rd Ste B, Valdosta, GA 31602 Phone: 229-259-0006 Fax: 229-259-0803 | |
Dana Woods Simpson, P.A. Physician Assistant Medicare: Medicare Enrolled Practice Location: 201 Woodrow Wilson Dr, Valdosta, GA 31602 Phone: 229-241-0041 Fax: 229-241-0048 | |
Matthew Allan Thomas, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2412 N Oak St, Valdosta, GA 31602 Phone: 229-244-1400 Fax: 229-244-5512 | |
Ms. Shonta K Winbush, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 704 Gil Harbin Ind Blvd, Valdosta, GA 31602 Phone: 229-242-9003 Fax: 229-242-0490 | |
Lela Faircloth Allen, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2412 N Oak St, Valdosta, GA 31602 Phone: 229-244-1400 Fax: 229-244-5512 |