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710 N Irwin Ave Ocilla GA 31774-5011 | |
(229) 468-3800 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 710 N Irwin Ave, Ocilla, Georgia |
Authorized Official Name and Position | Paige Wynn (CEO) |
Authorized Official Contact | 2294579484 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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710 N Irwin Ave Ocilla GA 31774-5011 Ph: (229) 468-3800 | 710 N Irwin Ave Ocilla GA 31774-5011 Ph: (229) 468-3800 |
NPI Number | 1487158135 |
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Provider Enumeration Date | 03/19/2018 |
Last Update Date | 02/22/2022 |
Medicare PECOS PAC ID | 9537592084 |
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Medicare Enrollment ID | O20191213002028 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487158135 | NPI | - | NPPES |
Provider Name | Ashfaq Saiyed |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1225119407 PECOS PAC ID: 7113925215 Enrollment ID: I20090727000165 |
Provider Name | Howard C Mcmahan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457473779 PECOS PAC ID: 9931010451 Enrollment ID: I20120305000405 |
Provider Name | Bridget M Walters |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669880456 PECOS PAC ID: 6507181955 Enrollment ID: I20150206001177 |
Provider Name | Alexander Blaine Warren |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144699141 PECOS PAC ID: 8123338647 Enrollment ID: I20151112000398 |
Provider Name | Jessica Marie Lyons |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285009555 PECOS PAC ID: 7315241072 Enrollment ID: I20160201002271 |
Provider Name | Keri Evans |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811351554 PECOS PAC ID: 6901198779 Enrollment ID: I20160714002134 |
Provider Name | Jacqueline O'kane |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1396085981 PECOS PAC ID: 3870815970 Enrollment ID: I20200720001770 |
Provider Name | Shonda Souther |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346938222 PECOS PAC ID: 3577929710 Enrollment ID: I20230515001096 |
Irwin Specialty Centers Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 N Irwin Ave, Ocilla, GA 31774 Phone: 229-468-3800 | |