| Memorial Satilla Specialists, Llc | |
|
1921 Alice St Ste B Waycross GA 31501-6200 | |
| (912) 490-0722 | |
| (912) 490-7227 |
| Full Name | Memorial Satilla Specialists, Llc |
|---|---|
| Speciality | General Practice |
| Location | 1921 Alice St Ste B, Waycross, Georgia |
| Authorized Official Name and Position | Robert Ali Faile (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8439567923 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Satilla Specialists, Llc 1921 Alice St Ste B Waycross GA 31501-6200 Ph: (912) 490-0722 | Memorial Satilla Specialists, Llc 1921 Alice St Ste B Waycross GA 31501-6200 Ph: (912) 490-0722 |
| NPI Number | 1295266955 |
|---|---|
| Provider Enumeration Date | 03/24/2017 |
| Last Update Date | 03/24/2017 |
| Medicare PECOS PAC ID | 5991074957 |
|---|---|
| Medicare Enrollment ID | O20170706002072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295266955 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Robert Sumner Pilcher |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376549170 PECOS PAC ID: 6901700798 Enrollment ID: I20031126000156 |
| Provider Name | Timothy T Catchings |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841239670 PECOS PAC ID: 3971403189 Enrollment ID: I20040113000348 |
| Provider Name | John F Michaels |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356381917 PECOS PAC ID: 2860382389 Enrollment ID: I20040318000471 |
| Provider Name | Jaymal R. Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962433599 PECOS PAC ID: 3779474010 Enrollment ID: I20040324000650 |
| Provider Name | Bruce G Tripp |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1982661641 PECOS PAC ID: 7315904620 Enrollment ID: I20041220000539 |
| Provider Name | Timothy A Jamieson |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1548251010 PECOS PAC ID: 4688631997 Enrollment ID: I20041220000719 |
| Provider Name | Sonja L Schoeppel |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1689631418 PECOS PAC ID: 7416914726 Enrollment ID: I20041227000519 |
| Provider Name | Jonathan Constantin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184627291 PECOS PAC ID: 7012959323 Enrollment ID: I20050526000577 |
| Provider Name | Kenyon M Meadows |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1891726451 PECOS PAC ID: 0749286136 Enrollment ID: I20081121000464 |
| Provider Name | Sigismund S Lee |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194974048 PECOS PAC ID: 4688727431 Enrollment ID: I20090728000048 |
| Provider Name | Manel D Nayak |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1902818073 PECOS PAC ID: 1951448216 Enrollment ID: I20091020000252 |
| Provider Name | Yolanda Borders |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841483914 PECOS PAC ID: 9537330774 Enrollment ID: I20110920000932 |
| Provider Name | Nimi P Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235410911 PECOS PAC ID: 6103073366 Enrollment ID: I20120823000726 |
| Provider Name | James H Extine |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609803477 PECOS PAC ID: 7416984307 Enrollment ID: I20140429001419 |
| Provider Name | Gregory D Kalv |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033347638 PECOS PAC ID: 6406095066 Enrollment ID: I20140905001099 |
| Provider Name | Mary H Benek |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1689088874 PECOS PAC ID: 9436378627 Enrollment ID: I20140922000601 |
| Provider Name | Donald P Prentiss |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275617839 PECOS PAC ID: 9436130507 Enrollment ID: I20150629001228 |
| Provider Name | Jennifer M Rafus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114007630 PECOS PAC ID: 1456330240 Enrollment ID: I20151020001759 |
| Provider Name | Tara D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134505118 PECOS PAC ID: 8628365335 Enrollment ID: I20160923001222 |
| Provider Name | Daniel J Fuchs |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1265727283 PECOS PAC ID: 6901100916 Enrollment ID: I20171120002071 |
| Provider Name | Traci Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407382021 PECOS PAC ID: 0143575308 Enrollment ID: I20180612002951 |
| Provider Name | Shayibu Harruna |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1134449192 PECOS PAC ID: 6305960816 Enrollment ID: I20180614001833 |
| Provider Name | Steven Michale Miller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124009774 PECOS PAC ID: 8628016094 Enrollment ID: I20190117002193 |
| Provider Name | Charles Jordy Rewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235695990 PECOS PAC ID: 2264774363 Enrollment ID: I20190419000084 |
| Provider Name | Jana Revels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336791425 PECOS PAC ID: 6103258611 Enrollment ID: I20191120003151 |
| Provider Name | Jonathan Callegari |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831571207 PECOS PAC ID: 1052629540 Enrollment ID: I20210916001356 |
| Provider Name | Gurpreet Johal |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1568751154 PECOS PAC ID: 6709007412 Enrollment ID: I20220121000017 |
| Provider Name | Babu V Chithriki |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437119054 PECOS PAC ID: 7618049594 Enrollment ID: I20220408001692 |
| Provider Name | Vishwajeth Bhagavan Bhoopalam |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1831119841 PECOS PAC ID: 7618974684 Enrollment ID: I20220628001502 |
| Provider Name | Philip Villiotte |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1881643443 PECOS PAC ID: 1153354253 Enrollment ID: I20220912001409 |
| Provider Name | Heidar Arjomand-fard |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831129006 PECOS PAC ID: 3971583915 Enrollment ID: I20221201000981 |
| Provider Name | Dhiraj Warman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184787509 PECOS PAC ID: 5597713560 Enrollment ID: I20230228001123 |
| Provider Name | Kalie Deann Mathis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679248124 PECOS PAC ID: 3173979192 Enrollment ID: I20231027001457 |
| Provider Name | Craig Alan Thompson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1689601627 PECOS PAC ID: 9234033085 Enrollment ID: I20240422001128 |
David H. Cheatham, M.d.,p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 Beacon St, Waycross, GA 31501 Phone: 912-285-2440 Fax: 912-287-0197 | |
Southeast Georgia Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 409 Uvalda St, Waycross, GA 31501 Phone: 912-283-1359 Fax: 912-283-1362 | |
Peter Wrobel Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1720 Old Reynolds St, Waycross, GA 31501 Phone: 912-283-1359 Fax: 912-283-1360 | |
Thornton Family Chiropractic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 Stephenson St, Waycross, GA 31501 Phone: 912-283-6043 Fax: 912-283-6043 | |
Southeast Internal Medicine Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 406 Riverside Dr, Waycross, GA 31501 Phone: 912-287-1555 | |
Packer Medical Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 709 Knight Ave, Waycross, GA 31501 Phone: 912-283-2311 Fax: 912-283-8204 | |
Satilla Family Medicine, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 407 W Oneida St, Waycross, GA 31501 Phone: 912-338-0065 Fax: 912-338-0920 |