| Greening Medical Inc | |
|
7285 Highway 16 Suite C Senoia GA 30276-3357 | |
| (770) 599-0505 | |
| (770) 599-3413 |
| Full Name | Greening Medical Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 7285 Highway 16, Senoia, Georgia |
| Authorized Official Name and Position | Billy E Greening (OWNER) |
| Authorized Official Contact | 7705990505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greening Medical Inc 7285 Highway 16 Suite C Senoia GA 30276-3357 Ph: (770) 599-0505 | Greening Medical Inc 7285 Highway 16 Suite C Senoia GA 30276-3357 Ph: (770) 599-0505 |
| NPI Number | 1114034998 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 11/02/2011 |
| Medicare PECOS PAC ID | 6103099544 |
|---|---|
| Medicare Enrollment ID | O20111101000326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114034998 | NPI | - | NPPES |
| 000711048Q | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 42585 (Georgia) | Primary |
| 208VP0000X | Pain Medicine - Pain Medicine | 55703 (Georgia) | Secondary |
| Provider Name | Billy E Greening |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659321099 PECOS PAC ID: 2567414642 Enrollment ID: I20050404000608 |
| Provider Name | Jodi Tallman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194188516 PECOS PAC ID: 0941591895 Enrollment ID: I20160623000883 |
| Provider Name | Deborah Mischelle Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013446111 PECOS PAC ID: 6608132881 Enrollment ID: I20171102003604 |
| Provider Name | Phyllis Kelly Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548872468 PECOS PAC ID: 7214344746 Enrollment ID: I20210330002283 |
Yourtown Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 48 Main St, Suite 3a, Senoia, GA 30276 Phone: 678-723-0400 Fax: 770-599-9779 |