Norman Park Family Medicine Clinic | |
139 East Broad Street Norman Park GA 31771 | |
(229) 769-3500 | |
(229) 769-3501 |
Full Name | Norman Park Family Medicine Clinic |
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Speciality | Clinic/Center |
Location | 139 East Broad Street, Norman Park, Georgia |
Authorized Official Name and Position | Stewart Merdian (DIRECTOR) |
Authorized Official Contact | 2298903531 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Norman Park Family Medicine Clinic Po Box 110 Norman Park GA 31771-0110 Ph: (229) 769-3500 | Norman Park Family Medicine Clinic 139 East Broad Street Norman Park GA 31771 Ph: (229) 769-3500 |
NPI Number | 1518398049 |
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Provider Enumeration Date | 12/10/2013 |
Last Update Date | 07/28/2023 |
Medicare PECOS PAC ID | 4082833546 |
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Medicare Enrollment ID | O20140915001944 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518398049 | NPI | - | NPPES |
11-8912 | Other | GA | MEDICARE PART A |
003155331A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (Georgia) | Primary |
Provider Name | Hope C Littleton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881765154 PECOS PAC ID: 3476534074 Enrollment ID: I20040528000676 |
Provider Name | Robert O Spruill |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609808179 PECOS PAC ID: 6507967866 Enrollment ID: I20070731000297 |
Provider Name | Justin A Baker |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1790707925 PECOS PAC ID: 5294739033 Enrollment ID: I20080429000440 |
Provider Name | Gary W Swartzentruber |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1083937908 PECOS PAC ID: 7719016575 Enrollment ID: I20100603000832 |
Provider Name | Carolyn Fowler |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780092684 PECOS PAC ID: 3577782036 Enrollment ID: I20140915002087 |
Provider Name | Katrina Freeman Sasine |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700416385 PECOS PAC ID: 8426489626 Enrollment ID: I20200706002482 |
Provider Name | Mary Catherine Duskin |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982124285 PECOS PAC ID: 3870918931 Enrollment ID: I20200806000906 |