| Restor Metabolix Of Blackshear | |
|
3345 Us Highway 84 Ste 102 Blackshear GA 31516-2160 | |
| (912) 208-3581 | |
| Not Available |
| Full Name | Restor Metabolix Of Blackshear |
|---|---|
| Speciality | Internal Medicine |
| Location | 3345 Us Highway 84 Ste 102, Blackshear, Georgia |
| Authorized Official Name and Position | Randall Crawford (MANAGER) |
| Authorized Official Contact | 9122083581 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restor Metabolix Of Blackshear 3345 Us Highway 84 Ste 102 Blackshear GA 31516-2160 Ph: (912) 208-3581 | Restor Metabolix Of Blackshear 3345 Us Highway 84 Ste 102 Blackshear GA 31516-2160 Ph: (912) 208-3581 |
| NPI Number | 1174287379 |
|---|---|
| Provider Enumeration Date | 10/25/2021 |
| Last Update Date | 11/11/2022 |
| Medicare PECOS PAC ID | 4385034461 |
|---|---|
| Medicare Enrollment ID | O20211203000832 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174287379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Errol G Graham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821081860 PECOS PAC ID: 0941214019 Enrollment ID: I20060127000167 |
| Provider Name | Michael G Moss |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851554935 PECOS PAC ID: 5092986679 Enrollment ID: I20110913000366 |
| Provider Name | Cynthia K Holton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912252792 PECOS PAC ID: 0547426025 Enrollment ID: I20120727000460 |
| Provider Name | Randall Crawford Jr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740678739 PECOS PAC ID: 6901124858 Enrollment ID: I20150406001498 |
| Provider Name | Rachel Lee Peterson Moss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811302029 PECOS PAC ID: 2365756558 Enrollment ID: I20150731016176 |
| Provider Name | Courtney Lofton Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043874050 PECOS PAC ID: 4981937927 Enrollment ID: I20190606002535 |
| Provider Name | Stephanie Lyne Chadwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376135798 PECOS PAC ID: 0345657300 Enrollment ID: I20210323001515 |
| Provider Name | Susan Deen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497536866 PECOS PAC ID: 2062868136 Enrollment ID: I20231025002478 |
Blackshear Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 E Carter Ave, Blackshear, GA 31516 Phone: 912-449-1501 Fax: 912-449-1517 | |
Appling Healthcare Group Of Blackshear Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3345 Us Highway 84 Ste 102, Blackshear, GA 31516 Phone: 912-705-4910 Fax: 912-705-4911 | |
Mckinney Community Health Ctr, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 623 Sycamore St, Blackshear, GA 31516 Phone: 912-449-3294 Fax: 912-287-1568 | |
B Well Family Practice, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3343 Us Highway 84 Ste 103, Blackshear, GA 31516 Phone: 912-807-9355 Fax: 912-514-1222 |