| Raymond L. Stovall, M.d., P.c. | |
|
600 Professional Dr Suite 150 Lawrenceville GA 30045-7651 | |
| (678) 376-1800 | |
| (678) 376-5500 |
| Full Name | Raymond L. Stovall, M.d., P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 600 Professional Dr, Lawrenceville, Georgia |
| Authorized Official Name and Position | Raymond L Stovall (OWNER) |
| Authorized Official Contact | 6783761800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Raymond L. Stovall, M.d., P.c. 600 Professional Dr Suite 150 Lawrenceville GA 30045-7651 Ph: (678) 376-1800 | Raymond L. Stovall, M.d., P.c. 600 Professional Dr Suite 150 Lawrenceville GA 30045-7651 Ph: (678) 376-1800 |
| NPI Number | 1003826041 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 06/18/2008 |
| Medicare PECOS PAC ID | 2567454572 |
|---|---|
| Medicare Enrollment ID | O20040331000767 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003826041 | NPI | - | NPPES |
| 00282675B | Medicaid | GA | |
| 10659984294 | Other | GA | HUMANA |
| 4031478 | Other | GA | AETNA |
| 52450038 | Other | GA | BLUE CROSS |
| 182686 | Other | GA | COVENTRY |
| 254743708 | Other | GA | HUMANA GOLD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 025291 (Georgia) | Primary |
| Provider Name | Raymond L Stovall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861402695 PECOS PAC ID: 7416949060 Enrollment ID: I20100202000003 |
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Physicians Pointe Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1925 Old Peachtree Rd Ne, Lawrenceville, GA 30043 Phone: 770-339-5999 Fax: 770-277-9159 | |
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Bennett H. Bruckner,m.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 575 Professional Dr, Suite 290, Lawrenceville, GA 30045 Phone: 770-962-9410 Fax: 770-962-8489 | |
Metabolic Health Of Lawrenceville Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 720 Old Snellville Hwy Ste 150, Lawrenceville, GA 30044 Phone: 678-431-1119 | |
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