| Southcoast Medical Group, Llc | |
|
330 Benefield Dr Savannah GA 31406-2604 | |
| (912) 303-3552 | |
| (912) 303-3506 |
| Full Name | Southcoast Medical Group, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 330 Benefield Dr, Savannah, Georgia |
| Authorized Official Name and Position | John Marrero (ADMINISTRATOR) |
| Authorized Official Contact | 9123033552 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southcoast Medical Group, Llc Po Box 15849 Savannah GA 31416-2549 Ph: (912) 303-3552 | Southcoast Medical Group, Llc 330 Benefield Dr Savannah GA 31406-2604 Ph: (912) 303-3552 |
| NPI Number | 1467451922 |
|---|---|
| Provider Enumeration Date | 07/18/2005 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9032013271 |
|---|---|
| Medicare Enrollment ID | O20040109000192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467451922 | NPI | - | NPPES |
| 909802000 | Medicaid | FL | |
| GPA3131 | Medicaid | SC | |
| GPA643 | Medicaid | SC |
| Provider Name | John Stripling |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1043248537 PECOS PAC ID: 0446145452 Enrollment ID: I20040218000838 |
| Provider Name | Benjamin L Watson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124027842 PECOS PAC ID: 0648168708 Enrollment ID: I20040309001170 |
| Provider Name | David Theodore Estle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235138777 PECOS PAC ID: 6103813522 Enrollment ID: I20040428000488 |
| Provider Name | Patricia P Shapiro |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821096645 PECOS PAC ID: 2062400872 Enrollment ID: I20040503000085 |
| Provider Name | Tammie E Walz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679572374 PECOS PAC ID: 7719976109 Enrollment ID: I20040511000272 |
| Provider Name | Jeffrey S Mandel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134128853 PECOS PAC ID: 7315921251 Enrollment ID: I20040617000112 |
| Provider Name | Todd E Lanier |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902800980 PECOS PAC ID: 6103801287 Enrollment ID: I20040622001421 |
| Provider Name | Stephanie D Croll |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1154347490 PECOS PAC ID: 4880670801 Enrollment ID: I20040629000525 |
| Provider Name | Christopher J Oldfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073512877 PECOS PAC ID: 0446232466 Enrollment ID: I20040702000279 |
| Provider Name | Earl S Yeager |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952300675 PECOS PAC ID: 1951371061 Enrollment ID: I20040727001311 |
| Provider Name | Micah D Riegner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073512802 PECOS PAC ID: 6608846571 Enrollment ID: I20040728000829 |
| Provider Name | Nenad R Avramovski |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1760480701 PECOS PAC ID: 2062482565 Enrollment ID: I20040730000815 |
| Provider Name | Mark T Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548232473 PECOS PAC ID: 3375515893 Enrollment ID: I20040806000221 |
| Provider Name | Larry N Elam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306844170 PECOS PAC ID: 2163495961 Enrollment ID: I20040819000122 |
| Provider Name | Firas Bannout |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912068768 PECOS PAC ID: 1759355985 Enrollment ID: I20040824000443 |
| Provider Name | Edward D Sammons |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104847425 PECOS PAC ID: 2264406123 Enrollment ID: I20040825000866 |
| Provider Name | Richard R Hightower |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487652285 PECOS PAC ID: 3870552359 Enrollment ID: I20041008001158 |
| Provider Name | Robert E Johnson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1093887820 PECOS PAC ID: 2567424997 Enrollment ID: I20041028000720 |
| Provider Name | Jack R Eades |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1992890727 PECOS PAC ID: 2567428352 Enrollment ID: I20041203000272 |
| Provider Name | Douglas A Perry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306844121 PECOS PAC ID: 0941253975 Enrollment ID: I20050302000033 |
| Provider Name | Wallace E Holland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972501799 PECOS PAC ID: 4789584590 Enrollment ID: I20050302000050 |
| Provider Name | David M Mozer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013916840 PECOS PAC ID: 8820032741 Enrollment ID: I20050613000327 |
| Provider Name | Wasil Khan |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1104828250 PECOS PAC ID: 0042248320 Enrollment ID: I20050728000357 |
| Provider Name | Edward M Hoffman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154313229 PECOS PAC ID: 5991742009 Enrollment ID: I20050913000689 |
| Provider Name | Geoffrey Peters |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215936828 PECOS PAC ID: 0244257657 Enrollment ID: I20051025000867 |
| Provider Name | Robert Bruce Remler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316946114 PECOS PAC ID: 9436170339 Enrollment ID: I20051214000128 |
| Provider Name | Hy C Sussman |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1962466888 PECOS PAC ID: 1355333774 Enrollment ID: I20060104000226 |
| Provider Name | Kristen Updegraff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538127519 PECOS PAC ID: 1254342512 Enrollment ID: I20060526000133 |
| Provider Name | Andrew A Wade |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013908292 PECOS PAC ID: 6608889779 Enrollment ID: I20060714000033 |
| Provider Name | Thomas Moriarity |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669443065 PECOS PAC ID: 2365473469 Enrollment ID: I20060811000428 |
| Provider Name | Michelle L Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932129822 PECOS PAC ID: 1759384662 Enrollment ID: I20060815000260 |
| Provider Name | William E Webb |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699797324 PECOS PAC ID: 3476557802 Enrollment ID: I20060828000004 |
| Provider Name | Regina B. Dandy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922064336 PECOS PAC ID: 6507860228 Enrollment ID: I20060911000427 |
| Provider Name | Russell L Sliker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245217983 PECOS PAC ID: 6103878210 Enrollment ID: I20061006000560 |
| Provider Name | Lucas Lewin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982700100 PECOS PAC ID: 4183621998 Enrollment ID: I20061108000261 |
| Provider Name | Gary Fischer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053427690 PECOS PAC ID: 6103846282 Enrollment ID: I20070206000147 |
| Provider Name | Sarah E Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922294909 PECOS PAC ID: 7719063957 Enrollment ID: I20080327000595 |
| Provider Name | Scott R Mcglynn |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922096106 PECOS PAC ID: 9537164199 Enrollment ID: I20080429000193 |
| Provider Name | Joe K Griffin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831198696 PECOS PAC ID: 8527138940 Enrollment ID: I20080528000307 |
| Provider Name | Ana Concepcion-castro |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1174508576 PECOS PAC ID: 0749376291 Enrollment ID: I20080716000573 |
| Provider Name | Amanda H Hendricks |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922044767 PECOS PAC ID: 1557421435 Enrollment ID: I20081121000512 |
| Provider Name | Nizar Samih Eskandar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1104833698 PECOS PAC ID: 4385746817 Enrollment ID: I20090114000449 |
| Provider Name | Cristine P Miclat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649418310 PECOS PAC ID: 3678620820 Enrollment ID: I20090406000252 |
| Provider Name | Sabin Tomus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689616963 PECOS PAC ID: 4486689775 Enrollment ID: I20091229000223 |
| Provider Name | Steven J Novack |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1366488504 PECOS PAC ID: 7810038874 Enrollment ID: I20100113000146 |
| Provider Name | Donald Keith Cobb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386688554 PECOS PAC ID: 2062553027 Enrollment ID: I20100113000184 |
| Provider Name | Bhavesh G Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619976222 PECOS PAC ID: 1658411467 Enrollment ID: I20100309000412 |
| Provider Name | Julio P Cortes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952309700 PECOS PAC ID: 4183764996 Enrollment ID: I20100309000559 |
| Provider Name | Robert P Jones |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194724914 PECOS PAC ID: 9133029945 Enrollment ID: I20100324000162 |
| Provider Name | Lisa M Bettio |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699774356 PECOS PAC ID: 7416083753 Enrollment ID: I20100326000039 |
| Provider Name | Keith M Seibert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467451211 PECOS PAC ID: 1557401361 Enrollment ID: I20100329000390 |
| Provider Name | Robert L. Weeks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487653168 PECOS PAC ID: 5193865913 Enrollment ID: I20100416000210 |
| Provider Name | Harresh B Dulamal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699773457 PECOS PAC ID: 8729128533 Enrollment ID: I20100429000901 |
| Provider Name | Christopher B Curry |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770581530 PECOS PAC ID: 5193852721 Enrollment ID: I20100429000915 |
| Provider Name | Troy A Murphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639178395 PECOS PAC ID: 7012057821 Enrollment ID: I20100506000570 |
| Provider Name | Richard S Roth |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1972502581 PECOS PAC ID: 8820138639 Enrollment ID: I20100525000638 |
| Provider Name | Stephen G. Hendrix |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1154329951 PECOS PAC ID: 6103966916 Enrollment ID: I20100603000336 |
| Provider Name | Douglas A Hanzel |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1548268337 PECOS PAC ID: 7719027523 Enrollment ID: I20100610000492 |
| Provider Name | Theodore Geffen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073511861 PECOS PAC ID: 4082754890 Enrollment ID: I20100610000537 |
| Provider Name | Hiem Thong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184623993 PECOS PAC ID: 4284774001 Enrollment ID: I20100728000352 |
| Provider Name | Sidney J Bolch |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639177595 PECOS PAC ID: 0143287714 Enrollment ID: I20100728000683 |
| Provider Name | Jules Victor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306845029 PECOS PAC ID: 1759281561 Enrollment ID: I20100827000586 |
| Provider Name | Victor Winthrop Rosenfeld |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407968290 PECOS PAC ID: 4385732882 Enrollment ID: I20101020000699 |
| Provider Name | Karen Lynn Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093886715 PECOS PAC ID: 2769677525 Enrollment ID: I20101108000117 |
| Provider Name | Melanie B Helmken |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114964152 PECOS PAC ID: 2567475866 Enrollment ID: I20101108000332 |
| Provider Name | Glen L Scarbrough |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164469177 PECOS PAC ID: 8921011222 Enrollment ID: I20101110000709 |
| Provider Name | Jules Toraya |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114970043 PECOS PAC ID: 1557374857 Enrollment ID: I20101119000234 |
| Provider Name | Heather Morgan Wallace |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336173574 PECOS PAC ID: 1658372636 Enrollment ID: I20101221000034 |
| Provider Name | Kerri Anne Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801096417 PECOS PAC ID: 4486835675 Enrollment ID: I20110222000104 |
| Provider Name | Michael Robert Cohen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316057821 PECOS PAC ID: 0446232128 Enrollment ID: I20110314000229 |
| Provider Name | Christine A Swords |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003105727 PECOS PAC ID: 9931384443 Enrollment ID: I20110427000466 |
| Provider Name | Adam Foster Novack |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265699433 PECOS PAC ID: 6800064247 Enrollment ID: I20110729000347 |
| Provider Name | Craig Kevin Skalla |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1265570691 PECOS PAC ID: 1052417342 Enrollment ID: I20111212000536 |
| Provider Name | Sarah Barbour |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1447434766 PECOS PAC ID: 9032387089 Enrollment ID: I20120424000634 |
| Provider Name | Jennifer D Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003185570 PECOS PAC ID: 7416112065 Enrollment ID: I20120703000637 |
| Provider Name | Jami Beth Scanlon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366545329 PECOS PAC ID: 3274799473 Enrollment ID: I20120716000140 |
| Provider Name | Jennfier H Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083962849 PECOS PAC ID: 0749432110 Enrollment ID: I20121211000115 |
| Provider Name | Garrett D White |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1225031842 PECOS PAC ID: 8729972831 Enrollment ID: I20130524000410 |
| Provider Name | Yael Rachel Elfassy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598081002 PECOS PAC ID: 2769626522 Enrollment ID: I20130917000327 |
| Provider Name | Arthur Carlson Kendig |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1861424046 PECOS PAC ID: 8325042419 Enrollment ID: I20131101001402 |
| Provider Name | Braxton Jordan Fields |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528220274 PECOS PAC ID: 8224268768 Enrollment ID: I20140303001583 |
| Provider Name | Lawrence Neil Odom |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679787261 PECOS PAC ID: 2567658586 Enrollment ID: I20140324001406 |
| Provider Name | Leland Reamer Dampier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821388893 PECOS PAC ID: 5496988206 Enrollment ID: I20140501001641 |
| Provider Name | Dacia Ranee Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255730586 PECOS PAC ID: 2567786940 Enrollment ID: I20150112002099 |
| Provider Name | Joseph E. Wilson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043338676 PECOS PAC ID: 0446292973 Enrollment ID: I20150309001862 |
| Provider Name | Kendra Keenan Seagraves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962800771 PECOS PAC ID: 8123347853 Enrollment ID: I20150501000167 |
| Provider Name | Susan Goethe Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750776720 PECOS PAC ID: 8325069586 Enrollment ID: I20150623002856 |
| Provider Name | Margaret Bates Mccormack |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376809053 PECOS PAC ID: 6608183421 Enrollment ID: I20150910003064 |
| Provider Name | Ryann E Cowart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982970760 PECOS PAC ID: 6406084771 Enrollment ID: I20150911002475 |
| Provider Name | Christa Lynn Jillard Ilic |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811125966 PECOS PAC ID: 4082831912 Enrollment ID: I20150925001187 |
| Provider Name | Tracy O. Cobb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013383876 PECOS PAC ID: 7214247394 Enrollment ID: I20151102000402 |
| Provider Name | Courtney Callaway Morton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821466392 PECOS PAC ID: 3779893110 Enrollment ID: I20151113002251 |
| Provider Name | Caitlin B Thomson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689924474 PECOS PAC ID: 0143523506 Enrollment ID: I20160120000247 |
| Provider Name | Caroline Kaufman Freeman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083020291 PECOS PAC ID: 2769704170 Enrollment ID: I20160425002059 |
| Provider Name | Dawn Anne Mace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629449285 PECOS PAC ID: 2365731841 Enrollment ID: I20160523002743 |
| Provider Name | Roy Devonne Flood |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1336124338 PECOS PAC ID: 6406805548 Enrollment ID: I20160701001576 |
| Provider Name | Walter Blun Bowden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336466366 PECOS PAC ID: 1456595651 Enrollment ID: I20160808002753 |
| Provider Name | Tiffanie Thomen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154703718 PECOS PAC ID: 9739473026 Enrollment ID: I20160809002654 |
| Provider Name | Ashley Marie Mcbride |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578016895 PECOS PAC ID: 2769777333 Enrollment ID: I20160822000601 |
| Provider Name | Robin O Hern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922298009 PECOS PAC ID: 5698061950 Enrollment ID: I20160913000926 |
| Provider Name | Ornela Ifti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720321136 PECOS PAC ID: 3274836689 Enrollment ID: I20160921002928 |
| Provider Name | Scott Edward Rojas |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1285609784 PECOS PAC ID: 5496705824 Enrollment ID: I20161003001021 |
| Provider Name | Scott Callaghan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497747018 PECOS PAC ID: 4385696582 Enrollment ID: I20161216001720 |
| Provider Name | Jessica Brooke Wren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124563713 PECOS PAC ID: 9335422849 Enrollment ID: I20170208000042 |
| Provider Name | Jamie L Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528507282 PECOS PAC ID: 6608143169 Enrollment ID: I20170605001416 |
| Provider Name | Sarah C Jarrell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104153030 PECOS PAC ID: 3072816990 Enrollment ID: I20170614000753 |
| Provider Name | Ksena Mclean Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558711127 PECOS PAC ID: 7810253689 Enrollment ID: I20171110000724 |
| Provider Name | Paige Elizabeth Pardue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942730999 PECOS PAC ID: 6901154020 Enrollment ID: I20180807001470 |
| Provider Name | William B Knight |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356621890 PECOS PAC ID: 9436467164 Enrollment ID: I20180820003665 |
| Provider Name | Leslie Birdsong Sizemore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356608723 PECOS PAC ID: 3870732357 Enrollment ID: I20181126001767 |
| Provider Name | Pamela Lynn Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528546652 PECOS PAC ID: 6204170822 Enrollment ID: I20181207000714 |
| Provider Name | Emma S Walker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316375017 PECOS PAC ID: 7113262957 Enrollment ID: I20181221002360 |
| Provider Name | Heather W E Latham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548691736 PECOS PAC ID: 5890915961 Enrollment ID: I20190213000005 |
Memorial Physicians Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4731 Waters Ave, Savannah, GA 31404 Phone: 912-350-4905 Fax: 912-350-4955 | |
Mppg, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4731 Waters Ave, Savannah, GA 31404 Phone: 912-350-4905 Fax: 912-350-4955 | |
Union Mission, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 Fahm St, Savannah, GA 31401 Phone: 912-495-8887 Fax: 912-495-8889 | |
Curtis V. Cooper Primary Health Care, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4451 Paulsen St, Savannah, GA 31405 Phone: 912-527-1005 Fax: 912-527-1126 | |
Dynamic Loop Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Bull St # 200, Savannah, GA 31401 Phone: 470-332-5035 Fax: 888-977-3104 | |
Community Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4395 Ogeechee Rd, Ste 209, Savannah, GA 31405 Phone: 912-335-8934 Fax: 912-228-3046 | |
Memorial Health Hospitalists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4700 Waters Ave, Memorial Health Hospitalists, Savannah, GA 31404 Phone: 912-350-2155 Fax: 912-350-2156 |