Southern Primary Care, Llc | |
197 Bass Rd Macon GA 31210-2060 | |
(478) 365-2164 | |
Not Available |
Full Name | Southern Primary Care, Llc |
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Speciality | Internal Medicine |
Location | 197 Bass Rd, Macon, Georgia |
Authorized Official Name and Position | Jayesh D Patel (BUSINESS OWNER) |
Authorized Official Contact | 4783652164 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Southern Primary Care, Llc 197 Bass Rd Macon GA 31210-2060 Ph: () - | Southern Primary Care, Llc 197 Bass Rd Macon GA 31210-2060 Ph: (478) 365-2164 |
NPI Number | 1225551328 |
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Provider Enumeration Date | 07/20/2017 |
Last Update Date | 01/21/2024 |
Medicare PECOS PAC ID | 3173897196 |
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Medicare Enrollment ID | O20170914001778 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225551328 | NPI | - | NPPES |
Provider Name | Cynthia Blair Chambless |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1063577500 PECOS PAC ID: 3779573027 Enrollment ID: I20040517001540 |
Provider Name | Michele A Sewell |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1649205642 PECOS PAC ID: 0547207193 Enrollment ID: I20050414000648 |
Provider Name | Jayesh D Patel |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1548385966 PECOS PAC ID: 3678757929 Enrollment ID: I20110411000489 |
Provider Name | Douglas Ray White |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1568683506 PECOS PAC ID: 1658516661 Enrollment ID: I20130322000120 |
Provider Name | Sharon Rouse |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740736602 PECOS PAC ID: 9234426420 Enrollment ID: I20161003002239 |
Provider Name | Crystal Bales |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417481516 PECOS PAC ID: 8426328592 Enrollment ID: I20170721002374 |
Provider Name | Dipenkumar Rameshchandra Patel |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1124407499 PECOS PAC ID: 2860701216 Enrollment ID: I20181009000715 |
Provider Name | Danielle Johnson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396398053 PECOS PAC ID: 3779916598 Enrollment ID: I20191210001220 |
Provider Name | Tracy Tarvers |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093315848 PECOS PAC ID: 3577957588 Enrollment ID: I20220308000587 |
Provider Name | Tonya Ann Burgamy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275274185 PECOS PAC ID: 3274912530 Enrollment ID: I20220617000394 |
Provider Name | Lindsey Marie Robinson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992436604 PECOS PAC ID: 4688056377 Enrollment ID: I20220727002595 |
Provider Name | Beverly Shaw |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023548591 PECOS PAC ID: 6305220088 Enrollment ID: I20220830000336 |
Provider Name | Amy Hicks |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023350618 PECOS PAC ID: 7012219397 Enrollment ID: I20230508000592 |
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