| Oconee Family Practice, Pc | |
|
1747 Langford Dr Bldg 400-105 Bogart GA 30622-2670 | |
| (706) 769-1100 | |
| (706) 310-9847 |
| Full Name | Oconee Family Practice, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1747 Langford Dr Bldg 400-105, Bogart, Georgia |
| Authorized Official Name and Position | Mark A. Earhart (CEO PHYSICIAN) |
| Authorized Official Contact | 7067691100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oconee Family Practice, Pc 1747 Langford Dr Bldg 400-105 Bogart GA 30622-2670 Ph: (706) 769-1100 | Oconee Family Practice, Pc 1747 Langford Dr Bldg 400-105 Bogart GA 30622-2670 Ph: (706) 769-1100 |
| NPI Number | 1134323033 |
|---|---|
| Provider Enumeration Date | 06/13/2007 |
| Last Update Date | 02/04/2013 |
| Medicare PECOS PAC ID | 9234127408 |
|---|---|
| Medicare Enrollment ID | O20040505000891 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134323033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 043361 (Georgia) | Primary |
| Provider Name | Mark Alan Earhart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073536439 PECOS PAC ID: 0244364834 Enrollment ID: I20100818000626 |
| Provider Name | Leigh Anne Landers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639690241 PECOS PAC ID: 7416205083 Enrollment ID: I20180730003664 |
| Provider Name | Christian Philip Gibbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467065433 PECOS PAC ID: 6406212885 Enrollment ID: I20230510002759 |
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