| Gastroenterology Of Northeast Georgia Pc | |
|
35 Hospital Rd Blairsville GA 30512-3139 | |
| (706) 745-8800 | |
| (706) 745-8805 |
| Full Name | Gastroenterology Of Northeast Georgia Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 35 Hospital Rd, Blairsville, Georgia |
| Authorized Official Name and Position | Scott W Ainsworth (CEO) |
| Authorized Official Contact | 7067458800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Of Northeast Georgia Pc Po Box 759 Blairsville GA 30514-0759 Ph: (706) 745-8800 | Gastroenterology Of Northeast Georgia Pc 35 Hospital Rd Blairsville GA 30512-3139 Ph: (706) 745-8800 |
| NPI Number | 1871529529 |
|---|---|
| Provider Enumeration Date | 06/24/2006 |
| Last Update Date | 05/07/2014 |
| Medicare PECOS PAC ID | 7214922707 |
|---|---|
| Medicare Enrollment ID | O20040415000357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871529529 | NPI | - | NPPES |
| 122605 | Other | GA | UNITED HEALTHCARE |
| 376554453A | Medicaid | GA | |
| 890633G | Medicaid | NC | |
| 435212000 | Other | GA | CHAMPUS/TRICARE |
| 005857 | Other | GA | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Scott W Ainsworth |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033196183 PECOS PAC ID: 7810887346 Enrollment ID: I20040318000577 |
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