Logan Balkcom, | |
901 18th St E, Tifton, GA 31794-3648 | |
(229) 382-7120 | |
Not Available |
Full Name | Logan Balkcom |
---|---|
Gender | Male |
Speciality | Anesthesiology Assistant |
Experience | 3 Years |
Location | 901 18th St E, Tifton, Georgia |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1891457768 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367H00000X | Anesthesiologist Assistant | 10709 (Georgia) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Tift Regional Medical Center | Tifton, GA | Hospital |
Cook Medical Center A Campus Of Tift Reg Med Ctr | Adel, GA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Tift Regional Health System Inc | 2062745169 | 278 |
Entity Name | Tift Regional Health System Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881203305 PECOS PAC ID: 2062745169 Enrollment ID: O20200217002409 |
Mailing Address | Practice Location Address |
---|---|
Logan Balkcom, 901 18th St E, Tifton, GA 31794-3648 Ph: (229) 382-7120 | Logan Balkcom, 901 18th St E, Tifton, GA 31794-3648 Ph: (229) 382-7120 |
Lacey Jackson Landon, AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 901 18th St E, Tifton, GA 31794 Phone: 229-382-7120 | |
Clinton Jeffery Brown, AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 901 18th St E, Tifton, GA 31794 Phone: 229-353-6208 Fax: 229-353-7722 | |
Mr. Manuel Chavez Jr., CAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 901 18th St E, Tifton, GA 31794 Phone: 229-353-7050 | |
Mr. Ian Michael Hester, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 901 18th St E, Tifton, GA 31794 Phone: 229-382-7120 |