Doerun Primary Care Clinic Llc | |
204 N Broad St Doerun GA 31744 | |
(229) 985-3320 | |
(229) 890-1282 |
Full Name | Doerun Primary Care Clinic Llc |
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Speciality | Family Medicine |
Location | 204 N Broad St, Doerun, Georgia |
Authorized Official Name and Position | Jayshree Bhavnani (CFO) |
Authorized Official Contact | 2298919131 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Doerun Primary Care Clinic Llc Po Box 2876 Moultrie GA 31776-2876 Ph: (229) 891-9131 | Doerun Primary Care Clinic Llc 204 N Broad St Doerun GA 31744 Ph: (229) 985-3320 |
NPI Number | 1891480653 |
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Provider Enumeration Date | 04/07/2023 |
Last Update Date | 07/28/2023 |
Medicare PECOS PAC ID | 4880051358 |
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Medicare Enrollment ID | O20230530000612 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891480653 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Hope C Littleton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881765154 PECOS PAC ID: 3476534074 Enrollment ID: I20040528000676 |
Provider Name | Mary Catherine Duskin |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982124285 PECOS PAC ID: 3870918931 Enrollment ID: I20200806000906 |
Provider Name | Stephen Yarbrough |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1659934438 PECOS PAC ID: 4789065921 Enrollment ID: I20220719001190 |
Provider Name | Ethan Mcbrayer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1821652843 PECOS PAC ID: 9335520204 Enrollment ID: I20220724000071 |
Doerun Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 128 West Broad Avenue, Doerun, GA 31744 Phone: 229-782-5227 Fax: 229-782-5228 | |
Doerun Family Medicine Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 128 West Broad Ave, Doerun, GA 31744 Phone: 229-891-9131 Fax: 229-891-9079 |