| Memorial Hospital And Manor | |
|
1500 E Shotwell St Bainbridge GA 39819-4256 | |
| (229) 246-3500 | |
| (229) 246-8142 |
| Full Name | Memorial Hospital And Manor |
|---|---|
| Speciality | Clinic/Center |
| Location | 1500 E Shotwell St, Bainbridge, Georgia |
| Authorized Official Name and Position | Karen Faircloth (CFO) |
| Authorized Official Contact | 2292468211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Hospital And Manor 1500 E Shotwell St Bainbridge GA 39819-4256 Ph: (229) 246-3500 | Memorial Hospital And Manor 1500 E Shotwell St Bainbridge GA 39819-4256 Ph: (229) 246-3500 |
| NPI Number | 1053388256 |
|---|---|
| Provider Enumeration Date | 03/07/2006 |
| Last Update Date | 01/27/2022 |
| Medicare PECOS PAC ID | 1658265137 |
|---|---|
| Medicare Enrollment ID | O20040216000016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053388256 | NPI | - | NPPES |
| 00001262T | Medicaid | GA | |
| 00001262S | Medicaid | GA | |
| 00141919A | Medicaid | GA | |
| 00001262A | Medicaid | GA | |
| 000307 | Other | GA | BLUE CROSS BLUE SHIELD |
| Provider Name | Raymond J Otis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104844422 PECOS PAC ID: 6608771852 Enrollment ID: I20031205000149 |
| Provider Name | Elizabeth G Hollis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609889021 PECOS PAC ID: 1850287483 Enrollment ID: I20040223000369 |
| Provider Name | Jon M Mcrae |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700890274 PECOS PAC ID: 6002704327 Enrollment ID: I20040310000815 |
| Provider Name | David D Swearingain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710990122 PECOS PAC ID: 8527046382 Enrollment ID: I20040709000198 |
| Provider Name | Victoria R Lewis Holland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487721718 PECOS PAC ID: 5193704963 Enrollment ID: I20040715000707 |
| Provider Name | Charles Semones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639110687 PECOS PAC ID: 3476542143 Enrollment ID: I20041122000173 |
| Provider Name | Wayne H Friedman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730247412 PECOS PAC ID: 3577596865 Enrollment ID: I20050916000396 |
| Provider Name | Charles A Walker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154389369 PECOS PAC ID: 3274545033 Enrollment ID: I20060616000027 |
| Provider Name | Kimberly A Harbin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790731867 PECOS PAC ID: 0941203590 Enrollment ID: I20060821000303 |
| Provider Name | Ovidiu Popa |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144277864 PECOS PAC ID: 4789689308 Enrollment ID: I20061003000352 |
| Provider Name | James M Cox |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124101514 PECOS PAC ID: 8921171927 Enrollment ID: I20080724000598 |
| Provider Name | Marc-andre Jean-gilles |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255573952 PECOS PAC ID: 3678627650 Enrollment ID: I20090811000503 |
| Provider Name | James S Cochran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437218112 PECOS PAC ID: 4284778812 Enrollment ID: I20100222000019 |
| Provider Name | Angela F Tyus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174851745 PECOS PAC ID: 1254467269 Enrollment ID: I20100330000180 |
| Provider Name | Jason B Moye |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629255252 PECOS PAC ID: 5597896522 Enrollment ID: I20100708000274 |
| Provider Name | Lisa Wooten Martin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457583239 PECOS PAC ID: 7416143466 Enrollment ID: I20101202000323 |
| Provider Name | Gordon C Miller |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881648681 PECOS PAC ID: 3375726227 Enrollment ID: I20110330000529 |
| Provider Name | Gloria Y Browne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831189984 PECOS PAC ID: 6507935111 Enrollment ID: I20110520000715 |
| Provider Name | Omar Al Haddad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598920951 PECOS PAC ID: 6103097571 Enrollment ID: I20110914000706 |
| Provider Name | Donald R Robinson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326060187 PECOS PAC ID: 4486828860 Enrollment ID: I20111121000653 |
| Provider Name | James A Wilson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669441903 PECOS PAC ID: 9931376399 Enrollment ID: I20120125000760 |
| Provider Name | Richard D Zlotnik |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780610584 PECOS PAC ID: 7113920471 Enrollment ID: I20121115000451 |
| Provider Name | Adrienne Crow |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538320668 PECOS PAC ID: 5799935599 Enrollment ID: I20141201001898 |
| Provider Name | Karren Lynn Elliott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447643176 PECOS PAC ID: 1052631389 Enrollment ID: I20150527002384 |
| Provider Name | Whitney Vance |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528328481 PECOS PAC ID: 3173789716 Enrollment ID: I20160901001826 |
| Provider Name | Tracy R Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932567708 PECOS PAC ID: 2365710472 Enrollment ID: I20170614000854 |
| Provider Name | George Joseph Myers |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013280353 PECOS PAC ID: 6305116708 Enrollment ID: I20170718001582 |
| Provider Name | Wesley Kyle Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144742735 PECOS PAC ID: 6103199278 Enrollment ID: I20170912001811 |
| Provider Name | Craig J Lenz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225476393 PECOS PAC ID: 2062716582 Enrollment ID: I20171114002327 |
| Provider Name | Breanna Lynn Darley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376029066 PECOS PAC ID: 7810240900 Enrollment ID: I20181018001912 |
| Provider Name | Robert Evan Smallwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225520679 PECOS PAC ID: 8820325848 Enrollment ID: I20201215003276 |
| Provider Name | Mary Claire Smallwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306338751 PECOS PAC ID: 0143653881 Enrollment ID: I20210903001034 |
| Provider Name | Sedra Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184207573 PECOS PAC ID: 9537561824 Enrollment ID: I20220301000643 |
| Provider Name | Macy Phillips Tabb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134756463 PECOS PAC ID: 4789006255 Enrollment ID: I20230921000248 |
Bainbridge Ophthalmology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 603 Wheat Ave Ste 650, Bainbridge, GA 39819 Phone: 229-243-6900 Fax: 229-243-6919 | |
Primary Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 S Blvd Dr, Bainbridge, GA 39819 Phone: 229-243-8000 Fax: 229-246-7026 | |
J Sydney Cochran, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1504 E Evans St, Bainbridge, GA 39819 Phone: 229-246-6600 | |
J. Sydney Cochran,mdpc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1504 E Evans St, Bainbridge, GA 39819 Phone: 229-246-6600 Fax: 229-246-9322 | |
Port City Family Medicine, L.l.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 Wheat Ave, Bainbridge, GA 39819 Phone: 229-243-1045 | |
Magnolia Womens Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 Miluli Ave, Bainbridge, GA 39819 Phone: 229-243-0152 Fax: 229-246-9945 |