| Piedmont Providers Llc | |
|
220 J L White Dr Ste 120 Jasper GA 30143-4894 | |
| (770) 801-2500 | |
| (770) 803-2121 |
| Full Name | Piedmont Providers Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 220 J L White Dr Ste 120, Jasper, Georgia |
| Authorized Official Name and Position | Christy Aquino (DIRECTOR, PROVIDER ENROLLMENT) |
| Authorized Official Contact | 4702713427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Piedmont Providers Llc Po Box 102321 Atlanta GA 30368-2321 Ph: (770) 801-2500 | Piedmont Providers Llc 220 J L White Dr Ste 120 Jasper GA 30143-4894 Ph: (770) 801-2500 |
| NPI Number | 1548273592 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 10/26/2021 |
| Medicare PECOS PAC ID | 9830082825 |
|---|---|
| Medicare Enrollment ID | O20040204000321 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548273592 | NPI | - | NPPES |
| 306264909A | Medicaid | GA | |
| GRP3809 | Other | GA | MEDICARE |
| CH4995 | Other | GA | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Georgia) | Primary |
| Provider Name | Sandea Greene-harris |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1295784429 PECOS PAC ID: 1759294671 Enrollment ID: I20031107000038 |
| Provider Name | Mark A Benak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972592475 PECOS PAC ID: 2668386806 Enrollment ID: I20031118000034 |
| Provider Name | Shannan H Dannunzio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346571536 PECOS PAC ID: 2062316078 Enrollment ID: I20031121000356 |
| Provider Name | Gregory M Oetting |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1710939889 PECOS PAC ID: 6204749500 Enrollment ID: I20031202000104 |
| Provider Name | Cargill H Alleyne |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1700995925 PECOS PAC ID: 2567362247 Enrollment ID: I20040109000699 |
| Provider Name | Samantha D Stoddard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811938111 PECOS PAC ID: 6103726898 Enrollment ID: I20040109000864 |
| Provider Name | Sabrina M Rene |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1710906607 PECOS PAC ID: 5496656043 Enrollment ID: I20040120000359 |
| Provider Name | Roger H Frankel |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1295811982 PECOS PAC ID: 9931098100 Enrollment ID: I20040318000583 |
| Provider Name | Robert G Solyomvari |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992750012 PECOS PAC ID: 6103813761 Enrollment ID: I20040427000928 |
| Provider Name | Laura E Prado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538165709 PECOS PAC ID: 9638167919 Enrollment ID: I20040505000128 |
| Provider Name | Regis William Haid |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1811992449 PECOS PAC ID: 7618861923 Enrollment ID: I20040525001617 |
| Provider Name | Andrea Bossie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033115142 PECOS PAC ID: 5496736217 Enrollment ID: I20040527000600 |
| Provider Name | Garnet R Craddock |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588646012 PECOS PAC ID: 7012902976 Enrollment ID: I20040616000327 |
| Provider Name | Frank S Powell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760466874 PECOS PAC ID: 0749275667 Enrollment ID: I20040616000613 |
| Provider Name | John C Schnars |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962405548 PECOS PAC ID: 4880678648 Enrollment ID: I20040617001022 |
| Provider Name | Vijay M Patel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1336123439 PECOS PAC ID: 0648265595 Enrollment ID: I20040618000451 |
| Provider Name | Paul Zolty |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1033117940 PECOS PAC ID: 5092703819 Enrollment ID: I20040618000581 |
| Provider Name | Rosa L Langella |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386606283 PECOS PAC ID: 0941114581 Enrollment ID: I20040621000277 |
| Provider Name | Charles V Slomka |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427032598 PECOS PAC ID: 3274528120 Enrollment ID: I20040622000291 |
| Provider Name | Heide H Moeling |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831172360 PECOS PAC ID: 2264417427 Enrollment ID: I20040622000383 |
| Provider Name | Clifford A Cranford |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447234836 PECOS PAC ID: 6002801966 Enrollment ID: I20040622000608 |
| Provider Name | Hisa Yamaguchi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538161195 PECOS PAC ID: 7911809769 Enrollment ID: I20040623000158 |
| Provider Name | Robin A Brackett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073670709 PECOS PAC ID: 8022095652 Enrollment ID: I20040701001051 |
| Provider Name | Brian G Holcomb |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1316042757 PECOS PAC ID: 3072418037 Enrollment ID: I20040708000143 |
| Provider Name | Ranjit Kaur Sethi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821270430 PECOS PAC ID: 7012995145 Enrollment ID: I20040713001301 |
| Provider Name | Brett A Bowie |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215026646 PECOS PAC ID: 7911986617 Enrollment ID: I20040716000120 |
| Provider Name | Manish P Govin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306826243 PECOS PAC ID: 6002880176 Enrollment ID: I20040824000747 |
| Provider Name | Richard J Kelly |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508820424 PECOS PAC ID: 4082689385 Enrollment ID: I20040831000678 |
| Provider Name | John T Williams |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437184306 PECOS PAC ID: 6608842323 Enrollment ID: I20040903000615 |
| Provider Name | George E Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033102454 PECOS PAC ID: 6002880721 Enrollment ID: I20041021000337 |
| Provider Name | Jeffrey Warren Ellis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093860090 PECOS PAC ID: 0547222697 Enrollment ID: I20041101000339 |
| Provider Name | Russell A Wilson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427057736 PECOS PAC ID: 5092778688 Enrollment ID: I20041104000918 |
| Provider Name | Shankar Kandaswamy |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1689657181 PECOS PAC ID: 8325015431 Enrollment ID: I20041116000484 |
| Provider Name | David J Gower |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1881670180 PECOS PAC ID: 5092771105 Enrollment ID: I20041213000056 |
| Provider Name | Russell F Pruitt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992886667 PECOS PAC ID: 2860440930 Enrollment ID: I20050105000490 |
| Provider Name | Samuel Szumstein |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790783603 PECOS PAC ID: 7012961022 Enrollment ID: I20050311000283 |
| Provider Name | Michael E Lynch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073519013 PECOS PAC ID: 7911952775 Enrollment ID: I20050316000714 |
| Provider Name | Jeffrey Lynn Frye |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689777047 PECOS PAC ID: 1153368469 Enrollment ID: I20050408000273 |
| Provider Name | Jennifer Lynn Jestel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710002225 PECOS PAC ID: 2466490149 Enrollment ID: I20050422000313 |
| Provider Name | Brett L Sandifer |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1285632190 PECOS PAC ID: 1951342229 Enrollment ID: I20050517000569 |
| Provider Name | Christopher S Russell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609866839 PECOS PAC ID: 4385685239 Enrollment ID: I20050520000290 |
| Provider Name | Lloyd T Winger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457350894 PECOS PAC ID: 1951339571 Enrollment ID: I20050803000697 |
| Provider Name | Sharon E Hodges |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1275513244 PECOS PAC ID: 2961431630 Enrollment ID: I20050812000077 |
| Provider Name | John B Bieltz |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1023003431 PECOS PAC ID: 3870523087 Enrollment ID: I20050817000713 |
| Provider Name | Carla E Crawford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902823784 PECOS PAC ID: 2860381894 Enrollment ID: I20050823000741 |
| Provider Name | Mark A Kozinn |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184696973 PECOS PAC ID: 8729011101 Enrollment ID: I20050915000858 |
| Provider Name | Roshan Shrestha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427191782 PECOS PAC ID: 0143204156 Enrollment ID: I20051005000561 |
| Provider Name | Michael Cheng |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1942303276 PECOS PAC ID: 9436174224 Enrollment ID: I20051011000547 |
| Provider Name | Adeel Rahman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225052442 PECOS PAC ID: 1052336187 Enrollment ID: I20051019000109 |
| Provider Name | Kelleen M Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295924058 PECOS PAC ID: 3274559224 Enrollment ID: I20051019000144 |
| Provider Name | Vonda R Ware |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144286865 PECOS PAC ID: 4587687850 Enrollment ID: I20060112000601 |
| Provider Name | Mark Burson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1104808229 PECOS PAC ID: 7113949728 Enrollment ID: I20060406000066 |
| Provider Name | David T Floyd |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1699783498 PECOS PAC ID: 2062436967 Enrollment ID: I20060413000101 |
| Provider Name | Brion J Lock |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1295785731 PECOS PAC ID: 0547279622 Enrollment ID: I20060418000588 |
| Provider Name | Donald Maynard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194772749 PECOS PAC ID: 3577575380 Enrollment ID: I20060619000027 |
| Provider Name | Mutinhima Moyo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497763015 PECOS PAC ID: 4486658119 Enrollment ID: I20060911000536 |
| Provider Name | Kendra Gamble-webb |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770517674 PECOS PAC ID: 2062417025 Enrollment ID: I20060926000001 |
| Provider Name | Michael C Thompson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184732521 PECOS PAC ID: 1759387137 Enrollment ID: I20061006000375 |
| Provider Name | Daniel S Faith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083684765 PECOS PAC ID: 5092716621 Enrollment ID: I20070125000102 |
| Provider Name | Thomas H Scouller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790838720 PECOS PAC ID: 2668576133 Enrollment ID: I20070323000112 |
| Provider Name | Stephen M Szabo |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1780662361 PECOS PAC ID: 3779596507 Enrollment ID: I20070402000318 |
| Provider Name | Barry J Jenkins |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1174687123 PECOS PAC ID: 3476659368 Enrollment ID: I20070510000042 |
| Provider Name | Jean M Guitton |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1114979242 PECOS PAC ID: 9638081268 Enrollment ID: I20070510000112 |
| Provider Name | Charles C Lassiter |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1386671998 PECOS PAC ID: 9739285560 Enrollment ID: I20070510000413 |
| Provider Name | Andrew A Kramer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063498756 PECOS PAC ID: 1254235864 Enrollment ID: I20070630000027 |
| Provider Name | Joseph Morris |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174740054 PECOS PAC ID: 6305946138 Enrollment ID: I20070710000304 |
| Provider Name | Oyeyemi K Amosu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740350255 PECOS PAC ID: 9133229487 Enrollment ID: I20070716000396 |
| Provider Name | Michele M Johnson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1295861342 PECOS PAC ID: 2769573070 Enrollment ID: I20070801000057 |
| Provider Name | Timothy B Brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255392346 PECOS PAC ID: 5193816957 Enrollment ID: I20070808000239 |
| Provider Name | Joshua H Wolf |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1982633780 PECOS PAC ID: 2062448079 Enrollment ID: I20070924000300 |
| Provider Name | David Bodne |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316944697 PECOS PAC ID: 6204936206 Enrollment ID: I20071207000651 |
| Provider Name | Walker G Carter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700962644 PECOS PAC ID: 4284710104 Enrollment ID: I20080318000474 |
| Provider Name | Chandar Bhimani |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1871654509 PECOS PAC ID: 1052363298 Enrollment ID: I20080326000387 |
| Provider Name | Andrew S Harper |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134129562 PECOS PAC ID: 6103903703 Enrollment ID: I20080407000569 |
| Provider Name | Miguel Tan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770518573 PECOS PAC ID: 8527083278 Enrollment ID: I20080408000247 |
| Provider Name | Steven R Whitworth |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881694388 PECOS PAC ID: 7113004342 Enrollment ID: I20080411000290 |
| Provider Name | Andrei I Serbanescu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528032703 PECOS PAC ID: 5698854552 Enrollment ID: I20080502000377 |
| Provider Name | Ellis V Hedaya |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528032596 PECOS PAC ID: 9638258593 Enrollment ID: I20080502000423 |
| Provider Name | Walter J Curran |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1326060773 PECOS PAC ID: 4385600907 Enrollment ID: I20080520000052 |
| Provider Name | Jermaine Marquette Jackson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1225214745 PECOS PAC ID: 0345226239 Enrollment ID: I20080603000004 |
| Provider Name | Chad I Case |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1780898338 PECOS PAC ID: 7618047671 Enrollment ID: I20080603000008 |
| Provider Name | David R Schmidt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366440992 PECOS PAC ID: 4082785043 Enrollment ID: I20080618000488 |
| Provider Name | Matthew M Mondi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720092471 PECOS PAC ID: 6002912250 Enrollment ID: I20080627000123 |
| Provider Name | Michael A Bakarich |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699790071 PECOS PAC ID: 3779527833 Enrollment ID: I20080709000579 |
| Provider Name | Harrison S Pollinger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659341188 PECOS PAC ID: 7113955154 Enrollment ID: I20080715000819 |
| Provider Name | Bijay Pandey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942417738 PECOS PAC ID: 5597839266 Enrollment ID: I20080730000351 |
| Provider Name | Nicole L Sroka |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1861668337 PECOS PAC ID: 4880760578 Enrollment ID: I20080903000506 |
| Provider Name | Tonja Freeman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134389562 PECOS PAC ID: 0446326193 Enrollment ID: I20080904000403 |
| Provider Name | Chad E Miller |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1538373071 PECOS PAC ID: 4385712389 Enrollment ID: I20081003000443 |
| Provider Name | Erinne Ayanna Graham |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447230461 PECOS PAC ID: 9638237118 Enrollment ID: I20081028000433 |
| Provider Name | John R Mcnair |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285619213 PECOS PAC ID: 1355409756 Enrollment ID: I20081028000638 |
| Provider Name | Tracy P Nicholas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003095977 PECOS PAC ID: 7416018502 Enrollment ID: I20081208000536 |
| Provider Name | Eric M Gibney |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1992899207 PECOS PAC ID: 6709818669 Enrollment ID: I20090112000484 |
| Provider Name | George William C Stone |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295850386 PECOS PAC ID: 1850456526 Enrollment ID: I20090212000130 |
| Provider Name | Alexander Gluzman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1194900704 PECOS PAC ID: 8628128121 Enrollment ID: I20090603000541 |
| Provider Name | Jonathan Tuttle |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1871708768 PECOS PAC ID: 5496806341 Enrollment ID: I20090706000537 |
| Provider Name | Leda Portia Gattoc |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1073751731 PECOS PAC ID: 5991856791 Enrollment ID: I20090707000294 |
| Provider Name | Kevin M Mcgill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144454497 PECOS PAC ID: 1658423470 Enrollment ID: I20090708000698 |
| Provider Name | Ian C Herskowitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295880680 PECOS PAC ID: 1153473921 Enrollment ID: I20090709000373 |
| Provider Name | Reshma Patel |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1760693519 PECOS PAC ID: 5799823175 Enrollment ID: I20091104000383 |
| Provider Name | Matthew S Pugliese |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1093927113 PECOS PAC ID: 2365580495 Enrollment ID: I20091111000160 |
| Provider Name | Robert W Gilbert |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881685816 PECOS PAC ID: 0143368076 Enrollment ID: I20091112000407 |
| Provider Name | Bradley J Battaglia |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619125754 PECOS PAC ID: 7315085909 Enrollment ID: I20091119000438 |
| Provider Name | Grace A Pilcher |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245200203 PECOS PAC ID: 9335289040 Enrollment ID: I20091210000337 |
| Provider Name | Rajesh G Laungani |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447452396 PECOS PAC ID: 7416098447 Enrollment ID: I20100112000715 |
| Provider Name | Tedman L Vance |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548223472 PECOS PAC ID: 6800989781 Enrollment ID: I20100203000467 |
| Provider Name | Douglas C Miller |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1073596193 PECOS PAC ID: 7911041215 Enrollment ID: I20100225000024 |
| Provider Name | Lance L Stein |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568558062 PECOS PAC ID: 5092841007 Enrollment ID: I20100330000153 |
| Provider Name | Benjamin C Rogers |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1528068046 PECOS PAC ID: 5799814059 Enrollment ID: I20100525000250 |
| Provider Name | Randy W Cooper |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083612352 PECOS PAC ID: 1658478839 Enrollment ID: I20100528000030 |
| Provider Name | Craig M Patterson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1063624377 PECOS PAC ID: 4789716234 Enrollment ID: I20100719000441 |
| Provider Name | Gregory Gibson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467489120 PECOS PAC ID: 1850498171 Enrollment ID: I20100803000066 |
| Provider Name | Steven Darby Wray |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1689679219 PECOS PAC ID: 1759354855 Enrollment ID: I20100810000211 |
| Provider Name | Cesar Y Figueroa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255386835 PECOS PAC ID: 8527955616 Enrollment ID: I20100816000474 |
| Provider Name | Joseph P Mims |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487694022 PECOS PAC ID: 7517091275 Enrollment ID: I20100817000428 |
| Provider Name | Christopher R Kuzniak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558418400 PECOS PAC ID: 3779607007 Enrollment ID: I20100824000416 |
| Provider Name | Cyril O Spann |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1578590469 PECOS PAC ID: 5890819064 Enrollment ID: I20100825000891 |
| Provider Name | Scott Kevin Carroll |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942229299 PECOS PAC ID: 6507868437 Enrollment ID: I20100826000602 |
| Provider Name | John Dudley Cheape |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1164505491 PECOS PAC ID: 6800970203 Enrollment ID: I20100831000383 |
| Provider Name | Dennis Edward Choat |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1346298213 PECOS PAC ID: 7618091307 Enrollment ID: I20100902000016 |
| Provider Name | Meghan Rae Kirkland |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205161965 PECOS PAC ID: 1052436300 Enrollment ID: I20100910000231 |
| Provider Name | Stuart J Simon |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1225036122 PECOS PAC ID: 8820113640 Enrollment ID: I20100917000094 |
| Provider Name | Aristidis Iatridis |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1952309957 PECOS PAC ID: 3577688258 Enrollment ID: I20100917000932 |
| Provider Name | John M White |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1689601379 PECOS PAC ID: 0446219828 Enrollment ID: I20100924000443 |
| Provider Name | William M Scaljon |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1164472643 PECOS PAC ID: 1254465552 Enrollment ID: I20101008000527 |
| Provider Name | George Bradford Cabe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528166972 PECOS PAC ID: 2264433200 Enrollment ID: I20101013000732 |
| Provider Name | Chris Charles Carlson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629062443 PECOS PAC ID: 8426241969 Enrollment ID: I20101018000300 |
| Provider Name | Jennifer L Gilligan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1376730887 PECOS PAC ID: 5193918464 Enrollment ID: I20101019000803 |
| Provider Name | Carliss C Graham |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1841441458 PECOS PAC ID: 1456544618 Enrollment ID: I20101020000262 |
| Provider Name | Gary Robert Gropper |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1164531844 PECOS PAC ID: 9537239538 Enrollment ID: I20101020000720 |
| Provider Name | Sriram Iyer Paramesh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912905860 PECOS PAC ID: 5193919660 Enrollment ID: I20101028000664 |
| Provider Name | Steven Edward Harris |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1346248267 PECOS PAC ID: 0143414193 Enrollment ID: I20101103000774 |
| Provider Name | Sundus Lodhi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1770682825 PECOS PAC ID: 6305848573 Enrollment ID: I20101108000157 |
| Provider Name | Zaneta Danette Romain |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1437386307 PECOS PAC ID: 7618162470 Enrollment ID: I20101108000202 |
| Provider Name | Sateesh Reddy Prakash |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205021482 PECOS PAC ID: 6002001666 Enrollment ID: I20101109001460 |
| Provider Name | Raymond A Rubin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033113691 PECOS PAC ID: 1355401456 Enrollment ID: I20101123000260 |
| Provider Name | Anthony Keith Martin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477570927 PECOS PAC ID: 0042299190 Enrollment ID: I20101129000182 |
| Provider Name | Christopher Shaw |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750366332 PECOS PAC ID: 2769679554 Enrollment ID: I20101206000821 |
| Provider Name | Anuradha Guthikonda |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1609197318 PECOS PAC ID: 3173710860 Enrollment ID: I20101207000824 |
| Provider Name | Barbara Joslow |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982669503 PECOS PAC ID: 3678762515 Enrollment ID: I20110107000865 |
| Provider Name | James S Franklin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891752960 PECOS PAC ID: 7517997786 Enrollment ID: I20110119000130 |
| Provider Name | Lindsey L Witt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275855504 PECOS PAC ID: 8820278146 Enrollment ID: I20110203000590 |
| Provider Name | Rosita S Shivdat-nanhoe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396971925 PECOS PAC ID: 7315127040 Enrollment ID: I20110214000267 |
| Provider Name | Russell A Flint |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962457895 PECOS PAC ID: 4284702432 Enrollment ID: I20110223001202 |
| Provider Name | Trang Mai Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073825501 PECOS PAC ID: 9638352834 Enrollment ID: I20110325000296 |
| Provider Name | Stephanie Nicole White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801128459 PECOS PAC ID: 1850574971 Enrollment ID: I20110328000728 |
| Provider Name | Susan M Mucha |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1447415906 PECOS PAC ID: 4082898044 Enrollment ID: I20110415000369 |
| Provider Name | Yodit Katrell Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508161555 PECOS PAC ID: 9032396411 Enrollment ID: I20110613000261 |
| Provider Name | Seth D Walker |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1104935469 PECOS PAC ID: 3870664014 Enrollment ID: I20110627000166 |
| Provider Name | David Michael Benglis |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1669675641 PECOS PAC ID: 3274711973 Enrollment ID: I20110628000842 |
| Provider Name | Amy H Case |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1467664466 PECOS PAC ID: 0042488348 Enrollment ID: I20110712000259 |
| Provider Name | Albert Jesse Schuette |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1558549295 PECOS PAC ID: 6901074111 Enrollment ID: I20110713000834 |
| Provider Name | Jessica S Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063701613 PECOS PAC ID: 4486822350 Enrollment ID: I20110720000142 |
| Provider Name | Nagamalar Raju |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285894188 PECOS PAC ID: 1355539982 Enrollment ID: I20110726000882 |
| Provider Name | Earl N Mullis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215962170 PECOS PAC ID: 5395798847 Enrollment ID: I20110816000391 |
| Provider Name | Karen Jerris Andry |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1285912477 PECOS PAC ID: 9032388681 Enrollment ID: I20110816000563 |
| Provider Name | Ryan Carrick |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1063542280 PECOS PAC ID: 3971784299 Enrollment ID: I20110823001034 |
| Provider Name | Jose F Lizcano-perez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649427592 PECOS PAC ID: 9032389663 Enrollment ID: I20110908002144 |
| Provider Name | Jacqueline D Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073771762 PECOS PAC ID: 5597936013 Enrollment ID: I20110914000024 |
| Provider Name | April Meredith Witzel |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1700174778 PECOS PAC ID: 7416128608 Enrollment ID: I20110920000336 |
| Provider Name | Harold B Harrison |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1285606517 PECOS PAC ID: 7719883875 Enrollment ID: I20110926000829 |
| Provider Name | Oluwaseun Cole |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164598264 PECOS PAC ID: 8527239292 Enrollment ID: I20110929000459 |
| Provider Name | Gregory Alvin Cumberbatch |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1952552945 PECOS PAC ID: 9537331079 Enrollment ID: I20111005000938 |
| Provider Name | Thomas C Woodyard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629002365 PECOS PAC ID: 6800931569 Enrollment ID: I20111020000620 |
| Provider Name | Sundip Somabhai Patel |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1487857025 PECOS PAC ID: 0648443408 Enrollment ID: I20111024000535 |
| Provider Name | David Green |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164607974 PECOS PAC ID: 5395911192 Enrollment ID: I20111228000582 |
| Provider Name | Charles B Hartley |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1659379642 PECOS PAC ID: 7719144484 Enrollment ID: I20120208000193 |
| Provider Name | Leena S John |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811254907 PECOS PAC ID: 2860655743 Enrollment ID: I20120514000468 |
| Provider Name | Fawzi T Mohammad |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346483484 PECOS PAC ID: 8921261728 Enrollment ID: I20120515000053 |
| Provider Name | Matthew Sand |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679779664 PECOS PAC ID: 9032365705 Enrollment ID: I20120813000207 |
| Provider Name | Devina Bhasin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063607109 PECOS PAC ID: 5799857371 Enrollment ID: I20120813000256 |
| Provider Name | Melissa B Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760739437 PECOS PAC ID: 7911155866 Enrollment ID: I20120918000460 |
| Provider Name | Kevin E Woods |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851437065 PECOS PAC ID: 9133377013 Enrollment ID: I20120918000891 |
| Provider Name | Mark E Mcclinton |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1558355263 PECOS PAC ID: 4385730852 Enrollment ID: I20120928000267 |
| Provider Name | Julie H Hausner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952655482 PECOS PAC ID: 7618129974 Enrollment ID: I20121212000532 |
| Provider Name | James B Dozier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720347065 PECOS PAC ID: 2769634724 Enrollment ID: I20121220000403 |
| Provider Name | Jonathan C Hundley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437168176 PECOS PAC ID: 3072408376 Enrollment ID: I20130213000240 |
| Provider Name | Fredicia L Stembridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134467301 PECOS PAC ID: 1456505767 Enrollment ID: I20130213000348 |
| Provider Name | Micah S Blackmon |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1588876411 PECOS PAC ID: 9032203971 Enrollment ID: I20130313000448 |
| Provider Name | Atrac A Kay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811188006 PECOS PAC ID: 4981849908 Enrollment ID: I20130322000291 |
| Provider Name | Katherine L Steele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144455643 PECOS PAC ID: 2466698501 Enrollment ID: I20130417000007 |
| Provider Name | Latoya B Stephens |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316106032 PECOS PAC ID: 6709023914 Enrollment ID: I20130507000650 |
| Provider Name | Megan B Potter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497835094 PECOS PAC ID: 8527205483 Enrollment ID: I20130513000504 |
| Provider Name | James M Stevens |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265680730 PECOS PAC ID: 5294973608 Enrollment ID: I20130524000104 |
| Provider Name | Scott E Bell |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1306992995 PECOS PAC ID: 5799925061 Enrollment ID: I20130710000077 |
| Provider Name | Mayur C Patel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1164603676 PECOS PAC ID: 9335227446 Enrollment ID: I20130715000314 |
| Provider Name | Huiming Hon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780854109 PECOS PAC ID: 5496996969 Enrollment ID: I20130725000427 |
| Provider Name | Curtrina F Strozier |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720215304 PECOS PAC ID: 8224279757 Enrollment ID: I20130726000058 |
| Provider Name | Patricia L Rich |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1386750149 PECOS PAC ID: 2961406442 Enrollment ID: I20130806000233 |
| Provider Name | Ralitza T Martin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1306011739 PECOS PAC ID: 9133361611 Enrollment ID: I20130813000394 |
| Provider Name | Eyal Meiri |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1194786947 PECOS PAC ID: 7618966839 Enrollment ID: I20130820000810 |
| Provider Name | Krishna J Goli |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932384427 PECOS PAC ID: 7416033477 Enrollment ID: I20130823000466 |
| Provider Name | Heidi T Woessner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225272941 PECOS PAC ID: 0749428928 Enrollment ID: I20130824000241 |
| Provider Name | Erin M Dunbar |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1235298779 PECOS PAC ID: 1355435470 Enrollment ID: I20130904000855 |
| Provider Name | Susan Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417389669 PECOS PAC ID: 3173757002 Enrollment ID: I20131009000811 |
| Provider Name | David J Poynter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033376439 PECOS PAC ID: 8820268972 Enrollment ID: I20131106001985 |
| Provider Name | Mary A Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003244021 PECOS PAC ID: 0042446866 Enrollment ID: I20131126000450 |
| Provider Name | Gathline Etienne |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366602005 PECOS PAC ID: 2961658562 Enrollment ID: I20131204002085 |
| Provider Name | Kevin Nguyen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598884413 PECOS PAC ID: 1658419320 Enrollment ID: I20140102001528 |
| Provider Name | Tara Phelps Gulsby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568897767 PECOS PAC ID: 9234369885 Enrollment ID: I20140227002188 |
| Provider Name | Christina L Klein |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1750428025 PECOS PAC ID: 4486634151 Enrollment ID: I20140305002095 |
| Provider Name | Erin M Goodman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487077533 PECOS PAC ID: 1052544756 Enrollment ID: I20140505000843 |
| Provider Name | Holly W Mitchell |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1225468028 PECOS PAC ID: 4082838966 Enrollment ID: I20140616001456 |
| Provider Name | Spencer Ian Kozinn |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1265603633 PECOS PAC ID: 7416197439 Enrollment ID: I20140711000816 |
| Provider Name | William E Philippi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881692010 PECOS PAC ID: 2264409242 Enrollment ID: I20140721000728 |
| Provider Name | Selishia M Mcfarlane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558774711 PECOS PAC ID: 3072730605 Enrollment ID: I20140805002822 |
| Provider Name | Elisabeth Curtis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700066172 PECOS PAC ID: 6709900699 Enrollment ID: I20140909000911 |
| Provider Name | Bradley D Hare |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013154632 PECOS PAC ID: 1658530753 Enrollment ID: I20140910000155 |
| Provider Name | Tai E Valliere-white |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669630893 PECOS PAC ID: 2668544875 Enrollment ID: I20140911001012 |
| Provider Name | Kimberly D Pegues |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073663167 PECOS PAC ID: 1850510959 Enrollment ID: I20140923001511 |
| Provider Name | Stephanie M Tarracciano |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194043844 PECOS PAC ID: 7214157676 Enrollment ID: I20141007000640 |
| Provider Name | Rakhi Kheraj |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376708586 PECOS PAC ID: 6002050838 Enrollment ID: I20141016001170 |
| Provider Name | Lori G Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811398001 PECOS PAC ID: 3173845351 Enrollment ID: I20141124001974 |
| Provider Name | Ogonna A Iwuora |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295969665 PECOS PAC ID: 9638491509 Enrollment ID: I20141203001539 |
| Provider Name | Yue Ying Flora Lee |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619106630 PECOS PAC ID: 5092037994 Enrollment ID: I20141203002693 |
| Provider Name | Laura Smith Irwin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851401178 PECOS PAC ID: 9133294549 Enrollment ID: I20141208001040 |
| Provider Name | Srinivasan Ganesan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124222526 PECOS PAC ID: 8123080678 Enrollment ID: I20141222000497 |
| Provider Name | Tia M Guster |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285896258 PECOS PAC ID: 7618124702 Enrollment ID: I20150115000526 |
| Provider Name | Bridget R Mclendon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598167694 PECOS PAC ID: 6709101264 Enrollment ID: I20150205000268 |
| Provider Name | Jawad A Ilyas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629276159 PECOS PAC ID: 6406922251 Enrollment ID: I20150331002110 |
| Provider Name | Michael Burton Dillon |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1346314069 PECOS PAC ID: 8123015641 Enrollment ID: I20150415000222 |
| Provider Name | Mehul R. Parikh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629231048 PECOS PAC ID: 3476874942 Enrollment ID: I20150609001838 |
| Provider Name | Morteza Azimian |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1295940229 PECOS PAC ID: 9830243799 Enrollment ID: I20150617003089 |
| Provider Name | Catherine Carman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588769541 PECOS PAC ID: 2668783465 Enrollment ID: I20150619002139 |
| Provider Name | Javeria Bhawal |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1285076893 PECOS PAC ID: 9133433899 Enrollment ID: I20150808015907 |
| Provider Name | Ashley J Kish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295112662 PECOS PAC ID: 4284948969 Enrollment ID: I20150810000825 |
| Provider Name | Andrew Page |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1164608014 PECOS PAC ID: 3678714540 Enrollment ID: I20150812006659 |
| Provider Name | Sherley Samuels |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770873929 PECOS PAC ID: 7810203650 Enrollment ID: I20150825003633 |
| Provider Name | Nazia Q Bandukwala |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1669601167 PECOS PAC ID: 8123335361 Enrollment ID: I20150921000744 |
| Provider Name | Rudolph Carlo King |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194797555 PECOS PAC ID: 4688820087 Enrollment ID: I20150929000388 |
| Provider Name | Wambui Machua |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1144541079 PECOS PAC ID: 3577871680 Enrollment ID: I20151008002261 |
| Provider Name | Aloice O Aluoch |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1245541259 PECOS PAC ID: 9436399128 Enrollment ID: I20151008003039 |
| Provider Name | Lily Jung Henson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639252661 PECOS PAC ID: 3476549601 Enrollment ID: I20151009001823 |
| Provider Name | Jane W Yoffe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790978914 PECOS PAC ID: 0042534885 Enrollment ID: I20151012001074 |
| Provider Name | Jhaelyn A Odom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104210194 PECOS PAC ID: 5890004618 Enrollment ID: I20151019001231 |
| Provider Name | Ankur Goel |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1598993016 PECOS PAC ID: 9133368400 Enrollment ID: I20151109000881 |
| Provider Name | Obiajulu C Okafor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558583658 PECOS PAC ID: 9739242983 Enrollment ID: I20151110003109 |
| Provider Name | Erin A Jolly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689777666 PECOS PAC ID: 6507028289 Enrollment ID: I20151112002541 |
| Provider Name | Maria E Traverso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619340965 PECOS PAC ID: 4486956539 Enrollment ID: I20160106000608 |
| Provider Name | Brenda Kay Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326419201 PECOS PAC ID: 3779886395 Enrollment ID: I20160114001642 |
| Provider Name | Carl I Gonzales |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1356668487 PECOS PAC ID: 6507169422 Enrollment ID: I20160126001892 |
| Provider Name | Brandon Lebron Griggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083072367 PECOS PAC ID: 2567767379 Enrollment ID: I20160216001602 |
| Provider Name | Robert Klafter |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1558360446 PECOS PAC ID: 0547346124 Enrollment ID: I20160413001800 |
| Provider Name | Audra D Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740653781 PECOS PAC ID: 4587963160 Enrollment ID: I20160503001696 |
| Provider Name | Nathaniel Hill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609066026 PECOS PAC ID: 5890861660 Enrollment ID: I20160615001865 |
| Provider Name | Mitzie-ann Davis |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1740473735 PECOS PAC ID: 2961797808 Enrollment ID: I20160817001092 |
| Provider Name | Curtis J Coley |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1316102502 PECOS PAC ID: 9335217629 Enrollment ID: I20160817001601 |
| Provider Name | Melissa J Gibbs |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942456462 PECOS PAC ID: 4587806005 Enrollment ID: I20160907000247 |
| Provider Name | Erik D Zarandy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700148293 PECOS PAC ID: 1759503741 Enrollment ID: I20160916000694 |
| Provider Name | Ogbonna C Ogbu |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1184883985 PECOS PAC ID: 1951589134 Enrollment ID: I20160921002149 |
| Provider Name | Ekinadese Aburime |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265693873 PECOS PAC ID: 3678899309 Enrollment ID: I20161005003104 |
| Provider Name | Arvind J Ponnambalam |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1073704581 PECOS PAC ID: 7113178070 Enrollment ID: I20161019002063 |
| Provider Name | Mala S Kaul |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1104830181 PECOS PAC ID: 9537168794 Enrollment ID: I20161019002474 |
| Provider Name | Elizabeth B Almon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801089206 PECOS PAC ID: 7214183532 Enrollment ID: I20161104001150 |
| Provider Name | Brooke Latterell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689969594 PECOS PAC ID: 9537448923 Enrollment ID: I20161107001530 |
| Provider Name | William E Norris |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1801988811 PECOS PAC ID: 7618037177 Enrollment ID: I20161212001714 |
| Provider Name | Jessica E Mccabe |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1982961827 PECOS PAC ID: 2860798709 Enrollment ID: I20161219001979 |
| Provider Name | Leslie K Tomek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982647228 PECOS PAC ID: 7214986108 Enrollment ID: I20161220002466 |
| Provider Name | Juan Israel Gaitan Rueda |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1720241094 PECOS PAC ID: 2567625999 Enrollment ID: I20170119001587 |
| Provider Name | Tiffany Jo Kuras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922558840 PECOS PAC ID: 4082998992 Enrollment ID: I20170221000750 |
| Provider Name | Ibrahim Wiah Adamu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013238245 PECOS PAC ID: 5991933103 Enrollment ID: I20170411001690 |
| Provider Name | Chasity Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194265546 PECOS PAC ID: 4486921657 Enrollment ID: I20170519000676 |
| Provider Name | William Statton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558564658 PECOS PAC ID: 3779675764 Enrollment ID: I20170607002007 |
| Provider Name | Damien M Hansra |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1225202427 PECOS PAC ID: 0042532939 Enrollment ID: I20170717003350 |
| Provider Name | Kyle Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386179257 PECOS PAC ID: 6002187739 Enrollment ID: I20170729000013 |
| Provider Name | Joseph J Bear |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1538304217 PECOS PAC ID: 9537307525 Enrollment ID: I20170810000708 |
| Provider Name | Roger Chen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1164786091 PECOS PAC ID: 8224276902 Enrollment ID: I20170812000302 |
| Provider Name | Kaslyn Monah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689075715 PECOS PAC ID: 9537486543 Enrollment ID: I20170824001975 |
| Provider Name | Ikemefula Ekekwe |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1952505570 PECOS PAC ID: 4789868654 Enrollment ID: I20170829002752 |
| Provider Name | Jane Woo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326208158 PECOS PAC ID: 4082744453 Enrollment ID: I20170906001741 |
| Provider Name | Veer Chahwala |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1801114335 PECOS PAC ID: 6406129808 Enrollment ID: I20170906004106 |
| Provider Name | Rahul Maheshwari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316237423 PECOS PAC ID: 7214239839 Enrollment ID: I20170912002145 |
| Provider Name | Steven Hanling |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619941994 PECOS PAC ID: 8628361755 Enrollment ID: I20170914004321 |
| Provider Name | Gregory Mitchell |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1275893398 PECOS PAC ID: 1355615295 Enrollment ID: I20170915002895 |
| Provider Name | Thomas Xu |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1063766160 PECOS PAC ID: 9133360217 Enrollment ID: I20170920002803 |
| Provider Name | Matthew Schmitt |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1144558545 PECOS PAC ID: 4981851045 Enrollment ID: I20170929002147 |
| Provider Name | Diana Durrance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356882252 PECOS PAC ID: 1153696703 Enrollment ID: I20171006001117 |
| Provider Name | Emmanuel Minja |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780844043 PECOS PAC ID: 2961713664 Enrollment ID: I20171009001248 |
| Provider Name | Harrison Goodno |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1942512959 PECOS PAC ID: 8729396213 Enrollment ID: I20171013001066 |
| Provider Name | Miriam Thomas |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1578823464 PECOS PAC ID: 8729205836 Enrollment ID: I20171017000724 |
| Provider Name | Obosa Osawe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831308675 PECOS PAC ID: 9032392907 Enrollment ID: I20171106003001 |
| Provider Name | Bethany Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285156745 PECOS PAC ID: 3779849898 Enrollment ID: I20171106003137 |
| Provider Name | Khushboo L Chokshi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1619269529 PECOS PAC ID: 3870859796 Enrollment ID: I20171113001890 |
| Provider Name | Codi Lane Rhear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235589318 PECOS PAC ID: 5294021069 Enrollment ID: I20171128003145 |
| Provider Name | Jessica Marie Burton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861903155 PECOS PAC ID: 6507123510 Enrollment ID: I20171129003227 |
| Provider Name | Jian Liang Pang |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1558637058 PECOS PAC ID: 8921306325 Enrollment ID: I20180111000776 |
| Provider Name | Sheela Lohiya |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1902124738 PECOS PAC ID: 5799927380 Enrollment ID: I20180127000089 |
| Provider Name | Ashley Deanne Cutini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366952475 PECOS PAC ID: 9234499237 Enrollment ID: I20180213001509 |
| Provider Name | Kelly Natasha Wood |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1710043492 PECOS PAC ID: 7214114644 Enrollment ID: I20180517002228 |
| Provider Name | Sheikh Faheem |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104251321 PECOS PAC ID: 0840556882 Enrollment ID: I20180625002324 |
| Provider Name | Jennifer Lynn Azelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295247401 PECOS PAC ID: 5991051526 Enrollment ID: I20180711003016 |
| Provider Name | Michael Shotwell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427021070 PECOS PAC ID: 1951320936 Enrollment ID: I20180716001209 |
| Provider Name | Richard Ulf David Hedelius |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1376703645 PECOS PAC ID: 7618114042 Enrollment ID: I20180813001092 |
| Provider Name | Hannah Dawn Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407358732 PECOS PAC ID: 5294085908 Enrollment ID: I20180829004750 |
| Provider Name | Pranam Kokilakumar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376938696 PECOS PAC ID: 2567746274 Enrollment ID: I20180905003725 |
| Provider Name | Jason Wells |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316159676 PECOS PAC ID: 1254580590 Enrollment ID: I20180913000774 |
| Provider Name | James Woojong Chang |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1952661969 PECOS PAC ID: 0244534758 Enrollment ID: I20180918001359 |
| Provider Name | Deena Holloway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396264008 PECOS PAC ID: 9436400777 Enrollment ID: I20180925002816 |
| Provider Name | Christopher Boyd Looney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740457373 PECOS PAC ID: 4284851783 Enrollment ID: I20181001002612 |
| Provider Name | David Jason Mccracken |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1881983492 PECOS PAC ID: 1052663937 Enrollment ID: I20181003001926 |
| Provider Name | Loan L Vu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780909879 PECOS PAC ID: 3870769557 Enrollment ID: I20181004003060 |
| Provider Name | Evan Weitman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972737674 PECOS PAC ID: 6406108257 Enrollment ID: I20181006000183 |
| Provider Name | Annie Quinn Morrissey |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1558527127 PECOS PAC ID: 7517004906 Enrollment ID: I20181008000308 |
| Provider Name | Eric Steven Bour |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548245913 PECOS PAC ID: 2466354493 Enrollment ID: I20181008003550 |
| Provider Name | Jerian Kishma Forbes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891277612 PECOS PAC ID: 2668725144 Enrollment ID: I20181030003325 |
| Provider Name | Asharul Usmani |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1013140227 PECOS PAC ID: 2860644325 Enrollment ID: I20181106001970 |
| Provider Name | Bronwen Halstead Nussloch Garner |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1588954796 PECOS PAC ID: 7810114782 Enrollment ID: I20181108000403 |
| Provider Name | Ginger K Hirsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427534502 PECOS PAC ID: 0749524940 Enrollment ID: I20181128003108 |
| Provider Name | Rebecca Grace Lopez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467718742 PECOS PAC ID: 1355613290 Enrollment ID: I20181203002713 |
| Provider Name | Elisheba Negesti Butts |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922413145 PECOS PAC ID: 2062704224 Enrollment ID: I20190108001650 |
| Provider Name | Kylie C Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811465263 PECOS PAC ID: 0143566091 Enrollment ID: I20190114001735 |
| Provider Name | Brittany Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639646961 PECOS PAC ID: 3173860848 Enrollment ID: I20190204001842 |
| Provider Name | Tiffeny S. Carroll |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174598585 PECOS PAC ID: 1355319971 Enrollment ID: I20190207001071 |
| Provider Name | Folashade O Alade |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1578731600 PECOS PAC ID: 8325125164 Enrollment ID: I20190208001265 |
| Provider Name | Kari Loucye Hurt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669943320 PECOS PAC ID: 8921348855 Enrollment ID: I20190312003340 |
| Provider Name | William Patrick Roche |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326396490 PECOS PAC ID: 9638479975 Enrollment ID: I20190313001229 |
| Provider Name | Candace Marie Gates |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790076693 PECOS PAC ID: 9032423900 Enrollment ID: I20190313002914 |
| Provider Name | Richard K Jacob |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316061179 PECOS PAC ID: 5597023028 Enrollment ID: I20190410000623 |
| Provider Name | Jonathan Howard Payne |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1649512039 PECOS PAC ID: 5890019681 Enrollment ID: I20190410001091 |
| Provider Name | Laura Jane Evors |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750526463 PECOS PAC ID: 2062656762 Enrollment ID: I20190426000312 |
| Provider Name | Rebecca Mims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215491428 PECOS PAC ID: 1658613054 Enrollment ID: I20190506001397 |
| Provider Name | Christopher Lepage Gaunder |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811133101 PECOS PAC ID: 8628353042 Enrollment ID: I20190508000626 |
| Provider Name | Stephen Dale Bovenkerk |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1760503171 PECOS PAC ID: 7315010410 Enrollment ID: I20190621000712 |
| Provider Name | Keri Davis Levin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194283465 PECOS PAC ID: 3971837071 Enrollment ID: I20190624002149 |
| Provider Name | Madiha Iqbal Khan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1710159488 PECOS PAC ID: 8325275522 Enrollment ID: I20190719001203 |
| Provider Name | Claro T Palma |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1679527063 PECOS PAC ID: 4587708201 Enrollment ID: I20190723002095 |
| Provider Name | Rahim Wooley |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1952643157 PECOS PAC ID: 6709112105 Enrollment ID: I20190723002268 |
| Provider Name | David Sarver |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1750624144 PECOS PAC ID: 7416273883 Enrollment ID: I20190727000374 |
| Provider Name | Joshua Thomas Wewel |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1700149184 PECOS PAC ID: 8325338585 Enrollment ID: I20190731003413 |
| Provider Name | Ashlie Arthur |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1558701847 PECOS PAC ID: 8628305745 Enrollment ID: I20190813001984 |
| Provider Name | Ashwin Murigeppa Sheelvanth |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1134115769 PECOS PAC ID: 6204895576 Enrollment ID: I20190813003706 |
| Provider Name | Juliana M Vera Ortiz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992068456 PECOS PAC ID: 7911235213 Enrollment ID: I20190823003590 |
| Provider Name | Ritika Mahajan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285947283 PECOS PAC ID: 4284868597 Enrollment ID: I20190904002779 |
| Provider Name | Keyasha Beaty Robbs |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679978241 PECOS PAC ID: 9436489069 Enrollment ID: I20190925001628 |
| Provider Name | Wedad Rahman |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1538588249 PECOS PAC ID: 7517284862 Enrollment ID: I20191009001885 |
| Provider Name | Kathleen H Giarla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184077174 PECOS PAC ID: 5193010627 Enrollment ID: I20191014001369 |
| Provider Name | Sonjia L Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225211204 PECOS PAC ID: 6901026921 Enrollment ID: I20191022000324 |
| Provider Name | Jeff Frederick Seebach |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851320857 PECOS PAC ID: 6709920721 Enrollment ID: I20191024002537 |
| Provider Name | Danielle Mccarthur |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245617505 PECOS PAC ID: 5597097410 Enrollment ID: I20191025002384 |
| Provider Name | Clark Kensinger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265759963 PECOS PAC ID: 9931479029 Enrollment ID: I20191029002714 |
| Provider Name | Radha Samtani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144882044 PECOS PAC ID: 1052643772 Enrollment ID: I20191030001853 |
| Provider Name | Komal Mehta |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1932529617 PECOS PAC ID: 5890027189 Enrollment ID: I20191106002048 |
| Provider Name | Pelumi Adedayo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881004497 PECOS PAC ID: 7911207618 Enrollment ID: I20191106002834 |
| Provider Name | Leonel Elias Carrasco Abinader |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1619224623 PECOS PAC ID: 5193060309 Enrollment ID: I20191107003257 |
| Provider Name | Ivania T Irby |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205369253 PECOS PAC ID: 3678808672 Enrollment ID: I20191212002845 |
| Provider Name | Margarette Damas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215134168 PECOS PAC ID: 3476440686 Enrollment ID: I20200127000050 |
| Provider Name | Nathan Duffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801431333 PECOS PAC ID: 9537595228 Enrollment ID: I20200128001089 |
| Provider Name | Saleh M Eftaiha |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538435268 PECOS PAC ID: 1951610146 Enrollment ID: I20200130002703 |
| Provider Name | Rebecca Carros Ambrose |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1922291004 PECOS PAC ID: 6709212145 Enrollment ID: I20200204001250 |
| Provider Name | Vladimir Zahradnik |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1528218393 PECOS PAC ID: 5496925471 Enrollment ID: I20200303002760 |
| Provider Name | Brooke Childers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194184408 PECOS PAC ID: 9133452816 Enrollment ID: I20200311000616 |
| Provider Name | Kimberly Jennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609227628 PECOS PAC ID: 6103107107 Enrollment ID: I20200323002413 |
| Provider Name | Steven Craig Brousell |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679991483 PECOS PAC ID: 8325476328 Enrollment ID: I20200324003293 |
| Provider Name | Michael Stiefel |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1427111681 PECOS PAC ID: 7911973417 Enrollment ID: I20200402003585 |
| Provider Name | Ae Mary V Irwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306498605 PECOS PAC ID: 0749619237 Enrollment ID: I20200403002599 |
| Provider Name | Brittny K White |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1861911943 PECOS PAC ID: 4880023936 Enrollment ID: I20200410002341 |
| Provider Name | Tyler J Kenning |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1427211259 PECOS PAC ID: 2668628173 Enrollment ID: I20200416003636 |
| Provider Name | Yvonne D Conaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114583101 PECOS PAC ID: 0345670188 Enrollment ID: I20200420001487 |
| Provider Name | Akshay Bhatnagar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407267511 PECOS PAC ID: 1759633027 Enrollment ID: I20200424002075 |
| Provider Name | Jason Pfluke |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568646362 PECOS PAC ID: 2567517626 Enrollment ID: I20200603002108 |
| Provider Name | Kashif Jafri |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1598025884 PECOS PAC ID: 2567773534 Enrollment ID: I20200618001501 |
| Provider Name | Jessica Cioffi |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1912132218 PECOS PAC ID: 8921221417 Enrollment ID: I20200625001133 |
| Provider Name | Carly Thamer Donnet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134772049 PECOS PAC ID: 4284056995 Enrollment ID: I20200626000111 |
| Provider Name | Mio Yanagisawa |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376955831 PECOS PAC ID: 3971926148 Enrollment ID: I20200706003147 |
| Provider Name | Jeshenna Watkins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437444122 PECOS PAC ID: 9537473426 Enrollment ID: I20200708002525 |
| Provider Name | Alexander Antoine Lemmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104168681 PECOS PAC ID: 6406150481 Enrollment ID: I20200710000836 |
| Provider Name | Edward M Timmins |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649290016 PECOS PAC ID: 2365474038 Enrollment ID: I20200714001443 |
| Provider Name | Olufisayo Otusanya |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1336552785 PECOS PAC ID: 7517212103 Enrollment ID: I20200723001116 |
| Provider Name | Ana Rossi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1629277710 PECOS PAC ID: 2264613330 Enrollment ID: I20200727001579 |
| Provider Name | Shahzad Ahmed |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114260833 PECOS PAC ID: 1759680788 Enrollment ID: I20200814002879 |
| Provider Name | Rebecca H O' Grady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942833413 PECOS PAC ID: 9931525961 Enrollment ID: I20200820001832 |
| Provider Name | Riikka Mohorn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992721500 PECOS PAC ID: 0547268435 Enrollment ID: I20200831002130 |
| Provider Name | Atul Kumar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316049257 PECOS PAC ID: 3072790831 Enrollment ID: I20200917001917 |
| Provider Name | Mitra D Poorak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881072940 PECOS PAC ID: 0547557159 Enrollment ID: I20200918000948 |
| Provider Name | Mohabe Vinson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1275767501 PECOS PAC ID: 2860621554 Enrollment ID: I20200929000842 |
| Provider Name | Kelley M Pruitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073174579 PECOS PAC ID: 5193142065 Enrollment ID: I20201007000430 |
| Provider Name | Kathleen Alexis Pulliam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992310718 PECOS PAC ID: 8022438548 Enrollment ID: I20201021001633 |
| Provider Name | Sharon J Holloway |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952783664 PECOS PAC ID: 3971913518 Enrollment ID: I20201110001097 |
| Provider Name | Mridula Vinjamuri |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1063613503 PECOS PAC ID: 9830280270 Enrollment ID: I20201119002761 |
| Provider Name | Lindsey Hixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497308316 PECOS PAC ID: 6800209354 Enrollment ID: I20201230002581 |
| Provider Name | Steven Austin Roth |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942386727 PECOS PAC ID: 6103850540 Enrollment ID: I20210120002029 |
| Provider Name | Robert C Allen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1124091939 PECOS PAC ID: 5294794723 Enrollment ID: I20210126000686 |
| Provider Name | Rachel Hollimon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528675881 PECOS PAC ID: 5496160251 Enrollment ID: I20210209002023 |
| Provider Name | Alexander Evans |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1407939754 PECOS PAC ID: 3274597919 Enrollment ID: I20210330001317 |
| Provider Name | Jeffrey Adam Sadowsky |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1275517336 PECOS PAC ID: 9638100035 Enrollment ID: I20210409001353 |
| Provider Name | Keisha C Maloney |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1992996540 PECOS PAC ID: 6406105261 Enrollment ID: I20210428002220 |
| Provider Name | Kevin Lie |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1659570455 PECOS PAC ID: 5092898510 Enrollment ID: I20210504002034 |
| Provider Name | Liliana Aguilar-pagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982202099 PECOS PAC ID: 0648689943 Enrollment ID: I20210517000768 |
| Provider Name | Shimool Rabbani |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1851772073 PECOS PAC ID: 8426307687 Enrollment ID: I20210602000228 |
| Provider Name | Georges Al-helou |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1992011175 PECOS PAC ID: 8325338841 Enrollment ID: I20210603002166 |
| Provider Name | Hershel Bhadsavle |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1568881639 PECOS PAC ID: 3779851761 Enrollment ID: I20210617001622 |
| Provider Name | Mena Kerolus |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1548607575 PECOS PAC ID: 4981995859 Enrollment ID: I20210802000733 |
| Provider Name | Aaron Sanders |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1821452277 PECOS PAC ID: 2062706070 Enrollment ID: I20210803002119 |
| Provider Name | Hadi Hatoum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891953378 PECOS PAC ID: 0143462275 Enrollment ID: I20210816002228 |
| Provider Name | Kendol Kirk Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013357375 PECOS PAC ID: 9739474172 Enrollment ID: I20210819002019 |
| Provider Name | Kawanjit Kaur Surapur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093120768 PECOS PAC ID: 1658697248 Enrollment ID: I20210819002992 |
| Provider Name | Trailokya Pandit |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1538329560 PECOS PAC ID: 4789877937 Enrollment ID: I20210901001822 |
| Provider Name | George I Crawford |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437116456 PECOS PAC ID: 4486684669 Enrollment ID: I20210908000857 |
| Provider Name | Yan Yu Chen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043741754 PECOS PAC ID: 1254738891 Enrollment ID: I20210923001741 |
| Provider Name | Christopher Jean-louis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477964278 PECOS PAC ID: 0840510038 Enrollment ID: I20210929000171 |
| Provider Name | Malek Mushref |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619339124 PECOS PAC ID: 4587956214 Enrollment ID: I20211006001374 |
| Provider Name | Gautham Chitragari |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1538546676 PECOS PAC ID: 0143517441 Enrollment ID: I20211007000657 |
| Provider Name | Tina Sharkey Nordeen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932789674 PECOS PAC ID: 9335547041 Enrollment ID: I20211011002938 |
| Provider Name | Shanker Rao Polsani |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1184853178 PECOS PAC ID: 2163672130 Enrollment ID: I20211012001462 |
| Provider Name | Sarah Kate Hartman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235806258 PECOS PAC ID: 3274931860 Enrollment ID: I20211012003189 |
| Provider Name | Jeffrey Wang |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1730573064 PECOS PAC ID: 6103145487 Enrollment ID: I20211019000270 |
| Provider Name | Katie Ann Gresham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003589631 PECOS PAC ID: 2264820596 Enrollment ID: I20211019002092 |
| Provider Name | Christian Strong |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1740627579 PECOS PAC ID: 6709101785 Enrollment ID: I20211028001552 |
| Provider Name | Candace Elaine Moody |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609816172 PECOS PAC ID: 6800785072 Enrollment ID: I20211102001505 |
| Provider Name | Windy Dean-colomb |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1821047465 PECOS PAC ID: 6305840976 Enrollment ID: I20211104002988 |
| Provider Name | Chukwuma O Ndibe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881824266 PECOS PAC ID: 6901046580 Enrollment ID: I20211123003323 |
| Provider Name | Samantha H Aitchison |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447405758 PECOS PAC ID: 5193964146 Enrollment ID: I20211124000222 |
| Provider Name | Gianina Usera |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1295040590 PECOS PAC ID: 7810139250 Enrollment ID: I20220105000334 |
| Provider Name | Darion Showell |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1740629096 PECOS PAC ID: 4486888039 Enrollment ID: I20220120001215 |
| Provider Name | Saeyoung Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316609464 PECOS PAC ID: 6507250396 Enrollment ID: I20220221000945 |
| Provider Name | Meredith Cherry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205478351 PECOS PAC ID: 1153716220 Enrollment ID: I20220328002445 |
| Provider Name | Olivia Bryant Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821741331 PECOS PAC ID: 6204222557 Enrollment ID: I20220413001419 |
| Provider Name | Henri R Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174276711 PECOS PAC ID: 9537555818 Enrollment ID: I20220414000152 |
| Provider Name | Mwaba Chisela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710631593 PECOS PAC ID: 0547656753 Enrollment ID: I20220414001566 |
| Provider Name | Christin-lauren Tanksley |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093177354 PECOS PAC ID: 6507253770 Enrollment ID: I20220419000874 |
| Provider Name | Salah Elsaharty |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982625224 PECOS PAC ID: 3072581800 Enrollment ID: I20220503002776 |
| Provider Name | Giridhar Vedula |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730387697 PECOS PAC ID: 1052467974 Enrollment ID: I20220519001786 |
| Provider Name | Ashlee Mccorkle-jamieson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902252539 PECOS PAC ID: 6406148907 Enrollment ID: I20220524000483 |
| Provider Name | Paula Song |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1548793714 PECOS PAC ID: 7911384342 Enrollment ID: I20220524001498 |
| Provider Name | Michael Chu |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1154718815 PECOS PAC ID: 7618264581 Enrollment ID: I20220524001979 |
| Provider Name | Hollie J Bauman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477034775 PECOS PAC ID: 2668726159 Enrollment ID: I20220603000956 |
| Provider Name | Charles C Farmer |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1245664440 PECOS PAC ID: 2264705938 Enrollment ID: I20220609001092 |
| Provider Name | Jeremy Courtney |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1407235682 PECOS PAC ID: 5991011280 Enrollment ID: I20220615001432 |
| Provider Name | Evan Johnson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023547890 PECOS PAC ID: 2567853666 Enrollment ID: I20220620000572 |
| Provider Name | Christopher David Vetter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609306646 PECOS PAC ID: 3375922149 Enrollment ID: I20220624001216 |
| Provider Name | Parita Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720468028 PECOS PAC ID: 5890008098 Enrollment ID: I20220713000999 |
| Provider Name | Walker Shearon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134655020 PECOS PAC ID: 4587045802 Enrollment ID: I20220718003939 |
| Provider Name | Laura German Horne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104565670 PECOS PAC ID: 6002298411 Enrollment ID: I20220802001670 |
| Provider Name | Tyler Evan Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932842341 PECOS PAC ID: 4880077593 Enrollment ID: I20220812002185 |
| Provider Name | Michael Brandon Williams |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558781344 PECOS PAC ID: 3173825346 Enrollment ID: I20220823000141 |
| Provider Name | Shaoxu Bing |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497287502 PECOS PAC ID: 7315210341 Enrollment ID: I20220906003340 |
| Provider Name | Skye Elizabeth Criswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730714189 PECOS PAC ID: 7810371945 Enrollment ID: I20220908001531 |
| Provider Name | Samuel Agyakwah Osei-bonsu |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1457617045 PECOS PAC ID: 1153696893 Enrollment ID: I20220908002889 |
| Provider Name | Joy Lynn Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912638024 PECOS PAC ID: 7012392715 Enrollment ID: I20220916000120 |
| Provider Name | Rita Jen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1215316658 PECOS PAC ID: 0446565477 Enrollment ID: I20221006001859 |
| Provider Name | Mai-lynn Bui |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730628579 PECOS PAC ID: 5395020838 Enrollment ID: I20221009000072 |
| Provider Name | Lori Ann Plummer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245651892 PECOS PAC ID: 8527444892 Enrollment ID: I20221011000614 |
| Provider Name | Sun Qiu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427586379 PECOS PAC ID: 8527338839 Enrollment ID: I20221019001530 |
| Provider Name | Rhonda Ann Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700394889 PECOS PAC ID: 0840666442 Enrollment ID: I20221024001248 |
| Provider Name | Dharmika Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033846498 PECOS PAC ID: 5991173528 Enrollment ID: I20221201001708 |
| Provider Name | Andrew Sloan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1952317554 PECOS PAC ID: 0345221347 Enrollment ID: I20221215001167 |
| Provider Name | Richard Landrigan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1295798619 PECOS PAC ID: 0446156921 Enrollment ID: I20221220000745 |
| Provider Name | Anne-marie Addleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912623646 PECOS PAC ID: 3971973694 Enrollment ID: I20221221001151 |
| Provider Name | Steven Kinsey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275506917 PECOS PAC ID: 6608806286 Enrollment ID: I20221221001347 |
| Provider Name | Jennifer Marie Pate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518023043 PECOS PAC ID: 9931579265 Enrollment ID: I20230103001907 |
| Provider Name | Miranda Epstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881330827 PECOS PAC ID: 0345610572 Enrollment ID: I20230105000417 |
| Provider Name | Erika Benjumea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255937306 PECOS PAC ID: 6305216417 Enrollment ID: I20230106001057 |
| Provider Name | James R Berry |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831170778 PECOS PAC ID: 5092706069 Enrollment ID: I20230123002199 |
| Provider Name | Shakese Melina Hudley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417337759 PECOS PAC ID: 9830426030 Enrollment ID: I20230125002291 |
| Provider Name | Aaron Mammoser |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164549895 PECOS PAC ID: 1557539012 Enrollment ID: I20230306000058 |
| Provider Name | Rachna Patel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1386024859 PECOS PAC ID: 5698027118 Enrollment ID: I20230310002557 |
| Provider Name | James Muccio |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1215936844 PECOS PAC ID: 5890742183 Enrollment ID: I20230313000976 |
| Provider Name | Julie Monteiro-pai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316503808 PECOS PAC ID: 0042549560 Enrollment ID: I20230322001217 |
| Provider Name | Leighton Harned |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1649708017 PECOS PAC ID: 9133494297 Enrollment ID: I20230417002596 |
| Provider Name | Edward N Misulis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902396559 PECOS PAC ID: 8123409125 Enrollment ID: I20230428000180 |
| Provider Name | Joseph R Dennison |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1902803091 PECOS PAC ID: 5496814485 Enrollment ID: I20230502001537 |
| Provider Name | Anne Hopkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487354080 PECOS PAC ID: 5294190831 Enrollment ID: I20230503002311 |
| Provider Name | Charles Ray Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326750563 PECOS PAC ID: 5092171777 Enrollment ID: I20230523001077 |
| Provider Name | Garrett Harp |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053677641 PECOS PAC ID: 6901120542 Enrollment ID: I20230608002264 |
| Provider Name | Victor Vahid Lami |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073969523 PECOS PAC ID: 4183055478 Enrollment ID: I20230621002570 |
| Provider Name | Jeffrey Shirley |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1689811200 PECOS PAC ID: 2961569017 Enrollment ID: I20230630001035 |
| Provider Name | Salim Amrani |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1295983195 PECOS PAC ID: 0042494882 Enrollment ID: I20230710002102 |
| Provider Name | Daniel Maxwell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457746687 PECOS PAC ID: 9032415732 Enrollment ID: I20230802000862 |
| Provider Name | Douglas Farquhar |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1851788608 PECOS PAC ID: 0941512784 Enrollment ID: I20230817003901 |
| Provider Name | Anjali Patel |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1801329404 PECOS PAC ID: 9436572310 Enrollment ID: I20230818002869 |
| Provider Name | Adam Stephen Alexander Gracon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760777056 PECOS PAC ID: 3678713328 Enrollment ID: I20230822003979 |
| Provider Name | Parth Sheth |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184114837 PECOS PAC ID: 8729325089 Enrollment ID: I20230824002376 |
| Provider Name | Melinda Victoria Bottenfield |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992299713 PECOS PAC ID: 3375890338 Enrollment ID: I20230825002776 |
| Provider Name | Jenna Corinne Coon Fussell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467938084 PECOS PAC ID: 3274887674 Enrollment ID: I20230915001005 |
| Provider Name | Jamaal Malcolm Michael Crawford |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891292744 PECOS PAC ID: 5092169516 Enrollment ID: I20231002001679 |
| Provider Name | Halle Sovich Breissinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952055949 PECOS PAC ID: 0446606107 Enrollment ID: I20231101000880 |
| Provider Name | Dionne Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164203204 PECOS PAC ID: 4183073588 Enrollment ID: I20231211002463 |
| Provider Name | Vanessa Goyes Ruiz |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1164809885 PECOS PAC ID: 6800192907 Enrollment ID: I20231219001189 |
| Provider Name | Yayu Zhong |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962907998 PECOS PAC ID: 3577914456 Enrollment ID: I20240104002040 |
| Provider Name | James Price |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902269988 PECOS PAC ID: 7517302987 Enrollment ID: I20240226002929 |
| Provider Name | Fatima Chantella Cameron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558134866 PECOS PAC ID: 7315382066 Enrollment ID: I20240304002725 |
| Provider Name | Theodore Nukes |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891766739 PECOS PAC ID: 2961472626 Enrollment ID: I20240321000587 |
| Provider Name | Antonio Tombo Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952183774 PECOS PAC ID: 5496192726 Enrollment ID: I20240322001157 |
| Provider Name | Diego Condes Diez Martinez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760802540 PECOS PAC ID: 7214267822 Enrollment ID: I20240408000140 |
| Provider Name | Soumya Shivashankar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881155588 PECOS PAC ID: 1951771245 Enrollment ID: I20240411002357 |
| Provider Name | Linet Campbell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255595153 PECOS PAC ID: 7719120054 Enrollment ID: I20240412000416 |
| Provider Name | Thomas Theocharides |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528014412 PECOS PAC ID: 7810908019 Enrollment ID: I20240417003731 |
| Provider Name | Kibwe Weaver |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013180876 PECOS PAC ID: 6103940663 Enrollment ID: I20240425002271 |
| Provider Name | Jared A White |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811101538 PECOS PAC ID: 3476724691 Enrollment ID: I20240605003195 |
| Provider Name | Tara Ortiz |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1669767240 PECOS PAC ID: 8426398462 Enrollment ID: I20240607000630 |
The Aicher Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 35 W Church St Ste 101, Jasper, GA 30143 Phone: 404-796-7011 Fax: 404-796-7099 | |
M & M Interventional Spine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 91 Sammy Mcghee Blvd Ste 101, Jasper, GA 30143 Phone: 706-253-3367 Fax: 706-253-3361 | |
Internal Medicine Associates Of Jasper, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 51 Gordon Rd, Suite 201, Jasper, GA 30143 Phone: 706-692-9768 Fax: 706-692-4040 | |
Jasper Family Health And Urgent Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14 Sammy Mcghee Boulevard, Suite 204, Jasper, GA 30143 Phone: 706-253-4224 | |
Ball Ground Family Practice,p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 91 Sammy Mcghee Blvd, Suite 101, Jasper, GA 30143 Phone: 706-253-6200 Fax: 706-253-6276 | |
Archway Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 735 Martin Rd, Suite A, Jasper, GA 30143 Phone: 706-253-3366 Fax: 706-253-2243 | |
Pickens Urgent Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 744 Noah Dr Ste 108-109, Jasper, GA 30143 Phone: 706-692-0119 |