| |
102 Bowens Mill Rd Douglas GA 31533-2250 | |
(912) 384-3838 | |
(912) 384-8847 |
Full Name | |
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Speciality | Internal Medicine |
Location | 102 Bowens Mill Rd, Douglas, Georgia |
Authorized Official Name and Position | Dennis Conrad Harper (OWNER) |
Authorized Official Contact | 9123843838 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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102 Nw Bowens Mill Road Douglas GA 31533-2252 Ph: (912) 384-3838 | 102 Bowens Mill Rd Douglas GA 31533-2250 Ph: (912) 384-3838 |
NPI Number | 1326245382 |
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Provider Enumeration Date | 07/02/2007 |
Last Update Date | 09/09/2020 |
Medicare PECOS PAC ID | 7618959594 |
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Medicare Enrollment ID | O20040603001243 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326245382 | NPI | - | NPPES |
843434306K | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Dennis C Harper |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1043203425 PECOS PAC ID: 3779565650 Enrollment ID: I20040604000387 |
Provider Name | Mallory L O'brien |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639311178 PECOS PAC ID: 3870890700 Enrollment ID: I20160321001728 |
Provider Name | Amy Michelle Whitley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518460781 PECOS PAC ID: 4789923756 Enrollment ID: I20190308002541 |
Provider Name | Laura Williams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710432109 PECOS PAC ID: 3173956836 Enrollment ID: I20191210003458 |
Provider Name | Candace M Billotte |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073367017 PECOS PAC ID: 0446782338 Enrollment ID: I20241016003913 |
Coffee Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Doctors Dr, Ste 224, Douglas, GA 31533 Phone: 912-384-2353 | |
Abigail Miller Family Medicine Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 Shirley Ave, Douglas, GA 31533 Phone: 912-384-7300 | |
Douglas Medical Specialist Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 Doctors Dr Ste 106, Douglas, GA 31533 Phone: 912-384-3338 Fax: 912-383-6365 | |
Coffee Family Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Doctors Dr, Suite 224, Douglas, GA 31533 Phone: 912-384-2353 |