Mark Fouts, | |
1621 N Roberts Rd Nw Ste 110, Kennesaw, GA 30144-3640 | |
(770) 702-1806 | |
Not Available |
Full Name | Mark Fouts |
---|---|
Gender | Male |
Speciality | Anesthesiology Assistant |
Experience | 9 Years |
Location | 1621 N Roberts Rd Nw Ste 110, Kennesaw, Georgia |
Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992257943 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367H00000X | Anesthesiologist Assistant | 008183 (Georgia) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Wellstar Paulding Hospital | Hiram, GA | Hospital |
Wellstar Cobb Hospital | Austell, GA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mak Anesthesia Holdings, Llc | 4284917204 | 170 |
Wellstar Medical Group, Llc | 6709065402 | 1917 |
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 |
Entity Name | Mak Anesthesia Holdings, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912452939 PECOS PAC ID: 4284917204 Enrollment ID: O20170216001563 |
Mailing Address | Practice Location Address |
---|---|
Mark Fouts, 1621 N Roberts Rd Nw Ste 110, Kennesaw, GA 30144-3640 Ph: () - | Mark Fouts, 1621 N Roberts Rd Nw Ste 110, Kennesaw, GA 30144-3640 Ph: (770) 702-1806 |
Tiffany L. Artman, PAAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 1640 Airport Rd Nw, Ste110, Kennesaw, GA 30144 Phone: 678-202-2074 Fax: 678-290-0479 | |
Donald Macneill, PAAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 1640 Airport Rd Nw, Ste 110, Kennesaw, GA 30144 Phone: 678-202-2074 Fax: 770-590-1442 | |
Charles Luther, Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 4295 Country Garden Walk Nw, Kennesaw, GA 30152 Phone: 401-301-7218 | |
Kaeli Surilla Dailey, Anesthesiologist Assistant Medicare: May Accept Medicare Assignments Practice Location: 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152 Phone: 770-702-1806 | |
Gary P Jones, PAAA Anesthesiologist Assistant Medicare: May Accept Medicare Assignments Practice Location: 1640 Airport Rd Nw, Ste 110, Kennesaw, GA 30144 Phone: 678-202-2074 | |
Brian Finke, PAAA Anesthesiologist Assistant Medicare: May Accept Medicare Assignments Practice Location: 1640 Airport Rd Nw, Ste 110, Kennesaw, GA 30144 Phone: 678-202-2074 Fax: 770-590-1442 | |
Brian West, CAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 1300 Ridenour Blvd Nw, Kennesaw, GA 30152 Phone: 770-702-1806 |