C. Wayne Dodgen, Md, Pc | |
107 Jackson Ave Suite A Thomaston GA 30286-3433 | |
(706) 647-8101 | |
(706) 647-8543 |
Full Name | C. Wayne Dodgen, Md, Pc |
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Speciality | Family Medicine |
Location | 107 Jackson Ave, Thomaston, Georgia |
Authorized Official Name and Position | Charles Wayne Dodgen (CEO) |
Authorized Official Contact | 7066478101 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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C. Wayne Dodgen, Md, Pc Po Box 4867 Macon GA 31208-4867 Ph: (706) 647-8101 | C. Wayne Dodgen, Md, Pc 107 Jackson Ave Suite A Thomaston GA 30286-3433 Ph: (706) 647-8101 |
NPI Number | 1104022425 |
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Provider Enumeration Date | 06/24/2007 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 1759417751 |
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Medicare Enrollment ID | O20100330000025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104022425 | NPI | - | NPPES |
11DO948247 | Other | GA | CLIA # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Georgia) | Primary |
Provider Name | Charles W Dodgen |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1104846625 PECOS PAC ID: 8022144021 Enrollment ID: I20100330000023 |
Provider Name | Diana Lynn Kreismanis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346885381 PECOS PAC ID: 4587070206 Enrollment ID: I20210304000369 |
Upson Family Physicians, Lc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 612 West Gordon Street, Suite C, Thomaston, GA 30286 Phone: 706-647-7009 Fax: 706-647-7014 | |
Careconnect Convenient Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 101 Deluxe Circle, Suite B, Thomaston, GA 30286 Phone: 706-647-7509 Fax: 706-647-6624 | |
Upson Family Medical Center ,llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1512 Highway 19 N, Thomaston, GA 30286 Phone: 706-647-2641 | |
Sabrina Lancaster Np-c Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 502 W Main St, Thomaston, GA 30286 Phone: 706-938-4483 Fax: 706-938-0777 | |
Thomaston Internal Medicine,l.l.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 Cherokee Rd, Thomaston, GA 30286 Phone: 706-647-3200 Fax: 706-647-2346 | |
Thomaston Medical Clinic, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 615 S Center St, Thomaston, GA 30286 Phone: 706-647-2147 Fax: 706-647-7229 |