| Acsh Primary Care Of Georgia, Llc | |
|
4861 Bill Gardner Pkwy Locust Grove GA 30248-3644 | |
| (770) 626-5740 | |
| (770) 626-5765 |
| Full Name | Acsh Primary Care Of Georgia, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4861 Bill Gardner Pkwy, Locust Grove, Georgia |
| Authorized Official Name and Position | Norman Winland (COO) |
| Authorized Official Contact | 4044651000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Acsh Primary Care Of Georgia, Llc Po Box 101047 Atlanta GA 30392-1047 Ph: (404) 465-1000 | Acsh Primary Care Of Georgia, Llc 4861 Bill Gardner Pkwy Locust Grove GA 30248-3644 Ph: (770) 626-5740 |
| NPI Number | 1598185548 |
|---|---|
| Provider Enumeration Date | 04/17/2014 |
| Last Update Date | 08/17/2015 |
| Medicare PECOS PAC ID | 3577886183 |
|---|---|
| Medicare Enrollment ID | O20150106000507 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598185548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Deborah K Prather |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063690964 PECOS PAC ID: 5991795759 Enrollment ID: I20040513001189 |
| Provider Name | Clinton A Carter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215902655 PECOS PAC ID: 1153360441 Enrollment ID: I20050426001361 |
| Provider Name | Jean M Armand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770641102 PECOS PAC ID: 9436177540 Enrollment ID: I20070110000240 |
| Provider Name | Arnold D Gaskin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588703730 PECOS PAC ID: 9739285677 Enrollment ID: I20080411000431 |
| Provider Name | Ruth Adene- Peter |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073704375 PECOS PAC ID: 6204960164 Enrollment ID: I20100813000283 |
| Provider Name | Kristy Z Levarity Conley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760672281 PECOS PAC ID: 6204021223 Enrollment ID: I20101116000318 |
| Provider Name | Kenya M Ragland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598066011 PECOS PAC ID: 7618158924 Enrollment ID: I20110221000058 |
| Provider Name | Tina Baker Paulk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568753754 PECOS PAC ID: 0840462982 Enrollment ID: I20111013000316 |
| Provider Name | Charles D. Lutin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881640266 PECOS PAC ID: 8729977996 Enrollment ID: I20120308000684 |
| Provider Name | Bobby Crocker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003086349 PECOS PAC ID: 6901193614 Enrollment ID: I20160923001218 |
Sushrut Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3778 Highway 42, Locust Grove, GA 30248 Phone: 678-610-6649 | |
Medcare Plus, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 300 Lester Mill Rd Ste 170, Locust Grove, GA 30248 Phone: 470-462-2330 | |
Four Corners Testing Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4050 Ga-42, Locust Grove, GA 30248 Phone: 206-371-3336 | |
Correctmed Locust Grove, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4861 Bill Gardner Pkwy, Suite 100, Locust Grove, GA 30248 Phone: 770-626-5740 Fax: 770-626-5750 | |
Locust Grove Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3778 Highway 42, Locust Grove, GA 30248 Phone: 678-610-6649 Fax: 678-610-6025 | |
Ga Gastro Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4865 Bill Gardner Pkwy, Locust Grove, GA 30248 Phone: 404-641-3345 |