Mr Manuel Chavez Jr, CAA | |
901 18th St E, Tifton, GA 31794-3648 | |
(229) 353-7050 | |
Not Available |
Full Name | Mr Manuel Chavez Jr |
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Gender | Male |
Speciality | Anesthesiologist Assistant |
Location | 901 18th St E, Tifton, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619690344 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367H00000X | Anesthesiologist Assistant | (Georgia) | Primary |
Entity Name | Tift Regional Health System Inc |
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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 |
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Mr Manuel Chavez Jr, CAA 901 18th St E, Tifton, GA 31794-3648 Ph: () - | Mr Manuel Chavez Jr, CAA 901 18th St E, Tifton, GA 31794-3648 Ph: (229) 353-7050 |
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. Ian Michael Hester, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 901 18th St E, Tifton, GA 31794 Phone: 229-382-7120 | |
Logan Balkcom, Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 901 18th St E, Tifton, GA 31794 Phone: 229-382-7120 |