| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 901 18th St E, Tifton, Georgia |
| Authorized Official Name and Position | Kim Wills (SVP, CFO) |
| Authorized Official Contact | 2293533397 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
901 18th St E Tifton GA 31794-3648 Ph: (229) 382-7120 | 901 18th St E Tifton GA 31794-3648 Ph: (229) 382-7120 |
| NPI Number | 1881203305 |
|---|---|
| Provider Enumeration Date | 07/30/2020 |
| Last Update Date | 07/21/2021 |
| Medicare PECOS PAC ID | 2062745169 |
|---|---|
| Medicare Enrollment ID | O20200217002409 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881203305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Suzanne E Patton |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1902801228 PECOS PAC ID: 4486552049 Enrollment ID: I20031222000227 |
| Provider Name | Ross G Moorman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972608982 PECOS PAC ID: 7214920578 Enrollment ID: I20040405000610 |
| Provider Name | Coretta Delia Keith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306884374 PECOS PAC ID: 7012908114 Enrollment ID: I20040519000092 |
| Provider Name | Cindy Mcneese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972795912 PECOS PAC ID: 5092796425 Enrollment ID: I20040601000217 |
| Provider Name | Carlyle W Harper |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356412720 PECOS PAC ID: 6901889971 Enrollment ID: I20040610000852 |
| Provider Name | Melvin L Fussell |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1699713594 PECOS PAC ID: 0941284921 Enrollment ID: I20040616001172 |
| Provider Name | Lisa F. Fowlkes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871504100 PECOS PAC ID: 7810971652 Enrollment ID: I20040617000857 |
| Provider Name | Olakunle B Aina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912906041 PECOS PAC ID: 8628057023 Enrollment ID: I20040719000903 |
| Provider Name | Brad E Lindsey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336141563 PECOS PAC ID: 3577535814 Enrollment ID: I20040809000339 |
| Provider Name | James E Mossell |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1720195837 PECOS PAC ID: 1557334448 Enrollment ID: I20040818000778 |
| Provider Name | Adam E Traill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124112867 PECOS PAC ID: 1951375500 Enrollment ID: I20040820000552 |
| Provider Name | Norris K Burton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578558805 PECOS PAC ID: 5395719637 Enrollment ID: I20040825000092 |
| Provider Name | Cameron D Nixon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619972304 PECOS PAC ID: 9436126422 Enrollment ID: I20040910000122 |
| Provider Name | Margaret A Richardson Nixon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225033921 PECOS PAC ID: 4789651779 Enrollment ID: I20040910000136 |
| Provider Name | Dennis G Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457422842 PECOS PAC ID: 3274592589 Enrollment ID: I20041007000047 |
| Provider Name | Heather M Stroh |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1710965843 PECOS PAC ID: 6002875606 Enrollment ID: I20041008000514 |
| Provider Name | Clinton J Brown |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1528138997 PECOS PAC ID: 1557320074 Enrollment ID: I20041008000750 |
| Provider Name | Ralph T Veazey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801966296 PECOS PAC ID: 4981664208 Enrollment ID: I20041012000865 |
| Provider Name | Nawar R Hajo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881641439 PECOS PAC ID: 0143123372 Enrollment ID: I20041019000880 |
| Provider Name | Paul Alphonse |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1720085624 PECOS PAC ID: 4486615457 Enrollment ID: I20041022000605 |
| Provider Name | Eddy N Duncan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1386609311 PECOS PAC ID: 5294797270 Enrollment ID: I20041102000223 |
| Provider Name | Willie W Tapp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104875012 PECOS PAC ID: 2961466917 Enrollment ID: I20041118000686 |
| Provider Name | Russell F Pruitt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992886667 PECOS PAC ID: 2860440930 Enrollment ID: I20050105000490 |
| Provider Name | Todd Lilje |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194895573 PECOS PAC ID: 7911965629 Enrollment ID: I20050131000213 |
| Provider Name | Kuldeep Singh Talwar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1225020522 PECOS PAC ID: 1658269428 Enrollment ID: I20050314000537 |
| Provider Name | Donovan K Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760483523 PECOS PAC ID: 9436185428 Enrollment ID: I20050712000061 |
| Provider Name | Edward William Hellman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548340284 PECOS PAC ID: 4082645809 Enrollment ID: I20050822001006 |
| Provider Name | Carolyn J Felton |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1396731162 PECOS PAC ID: 0446229249 Enrollment ID: I20050823000441 |
| Provider Name | Rodney D Tyson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962598458 PECOS PAC ID: 0840216222 Enrollment ID: I20051017000072 |
| Provider Name | Doris L Wilder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760476774 PECOS PAC ID: 8527017086 Enrollment ID: I20051107000338 |
| Provider Name | Thomas C Brandt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467483040 PECOS PAC ID: 1557389335 Enrollment ID: I20051110000166 |
| Provider Name | Judy E Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063481224 PECOS PAC ID: 1557380987 Enrollment ID: I20051115000900 |
| Provider Name | Cynthia L Phillips |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972539708 PECOS PAC ID: 7517976426 Enrollment ID: I20060420000118 |
| Provider Name | William J Kaiser |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003883612 PECOS PAC ID: 0941211478 Enrollment ID: I20060518000107 |
| Provider Name | William H Davis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497722193 PECOS PAC ID: 8325038235 Enrollment ID: I20060526000139 |
| Provider Name | Jitendra Gandhi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1184689614 PECOS PAC ID: 8820992811 Enrollment ID: I20060607000128 |
| Provider Name | Mina A Jacob |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730132556 PECOS PAC ID: 7315942166 Enrollment ID: I20060929000000 |
| Provider Name | Sarah L Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538178389 PECOS PAC ID: 8224033071 Enrollment ID: I20060929000001 |
| Provider Name | David R Atkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013926229 PECOS PAC ID: 2860498243 Enrollment ID: I20061006000356 |
| Provider Name | Mark T Brulte |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205931672 PECOS PAC ID: 8426055096 Enrollment ID: I20061025000267 |
| Provider Name | Craig Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194754697 PECOS PAC ID: 8123026069 Enrollment ID: I20061201000189 |
| Provider Name | Myron T Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275534190 PECOS PAC ID: 0042219529 Enrollment ID: I20061211000350 |
| Provider Name | William L Kreschollek |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518946730 PECOS PAC ID: 5193724623 Enrollment ID: I20061212000108 |
| Provider Name | Marcus L Williams |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417026436 PECOS PAC ID: 3971503301 Enrollment ID: I20070108000413 |
| Provider Name | David M Banks |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497740906 PECOS PAC ID: 0941200810 Enrollment ID: I20070109000007 |
| Provider Name | Richard Wheeler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619954112 PECOS PAC ID: 8022901438 Enrollment ID: I20070202000332 |
| Provider Name | Roland Wade Nash |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033197785 PECOS PAC ID: 6901881093 Enrollment ID: I20070305000440 |
| Provider Name | Ayaz J. Chaudhary |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1639289382 PECOS PAC ID: 5991788291 Enrollment ID: I20070501000285 |
| Provider Name | Keith N Phillippi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043202633 PECOS PAC ID: 8224935341 Enrollment ID: I20070508000403 |
| Provider Name | William Turton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235100678 PECOS PAC ID: 8325064603 Enrollment ID: I20070509000187 |
| Provider Name | William W Hancock |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265423339 PECOS PAC ID: 8325147853 Enrollment ID: I20070625000653 |
| Provider Name | David J Wykstra |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285855148 PECOS PAC ID: 3476645771 Enrollment ID: I20070816000255 |
| Provider Name | Olushesan M Ogundipe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194915470 PECOS PAC ID: 0143312132 Enrollment ID: I20070822000907 |
| Provider Name | David A Burns |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316999832 PECOS PAC ID: 5698763126 Enrollment ID: I20070828000944 |
| Provider Name | Nancy Maignan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114971207 PECOS PAC ID: 1355337361 Enrollment ID: I20071019000253 |
| Provider Name | Priscilla R Greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184731564 PECOS PAC ID: 3678654985 Enrollment ID: I20080112000081 |
| Provider Name | James S Wang |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255313631 PECOS PAC ID: 2264470244 Enrollment ID: I20080324000408 |
| Provider Name | Ifeoma L Okafor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033226832 PECOS PAC ID: 4284665019 Enrollment ID: I20080423000299 |
| Provider Name | Joel L Cohen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841265717 PECOS PAC ID: 2264480334 Enrollment ID: I20080502000002 |
| Provider Name | Nadene C Fair |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043482151 PECOS PAC ID: 3678643418 Enrollment ID: I20080605000008 |
| Provider Name | Jeffry J Peters |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1265492326 PECOS PAC ID: 9739271628 Enrollment ID: I20080707000628 |
| Provider Name | Robert G Anderson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1437119583 PECOS PAC ID: 6002908993 Enrollment ID: I20080707000659 |
| Provider Name | Nikkia F Johnson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750402731 PECOS PAC ID: 1759454705 Enrollment ID: I20080723000892 |
| Provider Name | Mufaddal F Kheda |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1083734982 PECOS PAC ID: 6002980448 Enrollment ID: I20080804000456 |
| Provider Name | Barbara T Lewis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245417401 PECOS PAC ID: 3173698701 Enrollment ID: I20080818000144 |
| Provider Name | Sonia Wiggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063676146 PECOS PAC ID: 0345315701 Enrollment ID: I20080819000692 |
| Provider Name | Joseph Turner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326047838 PECOS PAC ID: 4789747452 Enrollment ID: I20090107000479 |
| Provider Name | Jonathan W Tronolone |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376626432 PECOS PAC ID: 9537253950 Enrollment ID: I20090507000440 |
| Provider Name | Cynthia J Westberry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942495833 PECOS PAC ID: 5890844674 Enrollment ID: I20090527000578 |
| Provider Name | Melanie Eller Lindsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578529913 PECOS PAC ID: 7517923303 Enrollment ID: I20090701000194 |
| Provider Name | Eugene Y Sun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730398496 PECOS PAC ID: 9638221161 Enrollment ID: I20090715000108 |
| Provider Name | Enrique Galliano |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205907680 PECOS PAC ID: 6901958941 Enrollment ID: I20090722000226 |
| Provider Name | Eric M Paulk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760673420 PECOS PAC ID: 9638247430 Enrollment ID: I20090722000467 |
| Provider Name | Ryan L Byrnes |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1215174446 PECOS PAC ID: 3870647894 Enrollment ID: I20090810000681 |
| Provider Name | Penny D Booth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710078423 PECOS PAC ID: 6002831096 Enrollment ID: I20090812000284 |
| Provider Name | Alpa H Ray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891906350 PECOS PAC ID: 2163576281 Enrollment ID: I20090824000472 |
| Provider Name | Justin F Harrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285756163 PECOS PAC ID: 7719055359 Enrollment ID: I20090922000052 |
| Provider Name | Akinloye J Makanjuola |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1760416077 PECOS PAC ID: 8123084894 Enrollment ID: I20091013000515 |
| Provider Name | Jason M Geddings |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1497080659 PECOS PAC ID: 4486791423 Enrollment ID: I20091026000014 |
| Provider Name | Erin R Borowski |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1427383652 PECOS PAC ID: 3971641754 Enrollment ID: I20091116000525 |
| Provider Name | Tedman L Vance |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548223472 PECOS PAC ID: 6800989781 Enrollment ID: I20100203000467 |
| Provider Name | Robert J Hawes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518036623 PECOS PAC ID: 3678617644 Enrollment ID: I20100216000001 |
| Provider Name | Autumn D Griffin |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689865057 PECOS PAC ID: 0840334694 Enrollment ID: I20100218000071 |
| Provider Name | Betty J Walker Richardson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679572648 PECOS PAC ID: 6204961212 Enrollment ID: I20100316000699 |
| Provider Name | Bonni Cohen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861535296 PECOS PAC ID: 6901902923 Enrollment ID: I20100521000310 |
| Provider Name | Brian Vickery |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588986335 PECOS PAC ID: 7315079472 Enrollment ID: I20100726000143 |
| Provider Name | Gary Baxter |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780676940 PECOS PAC ID: 0042117160 Enrollment ID: I20100726000219 |
| Provider Name | Raleigh Haynes |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477555183 PECOS PAC ID: 5597662619 Enrollment ID: I20100726000257 |
| Provider Name | Jessica W Beier |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1366437444 PECOS PAC ID: 0840207841 Enrollment ID: I20100804000598 |
| Provider Name | James L Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730182106 PECOS PAC ID: 1951435726 Enrollment ID: I20100816000413 |
| Provider Name | Richard E Mccullough |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336143619 PECOS PAC ID: 8022189802 Enrollment ID: I20100824000761 |
| Provider Name | Charles Derron Spikes |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1821128778 PECOS PAC ID: 9931224581 Enrollment ID: I20100920000353 |
| Provider Name | William Morgan Smith |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730269473 PECOS PAC ID: 6305877119 Enrollment ID: I20100921000055 |
| Provider Name | James Macdonald |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1639164296 PECOS PAC ID: 6608068069 Enrollment ID: I20101005000089 |
| Provider Name | Pamela K Willingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477662054 PECOS PAC ID: 2466644711 Enrollment ID: I20101006000008 |
| Provider Name | Cyriacus Anaele |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942456256 PECOS PAC ID: 2769541366 Enrollment ID: I20101015000725 |
| Provider Name | Absar Ahmad Mirza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265415541 PECOS PAC ID: 1153219027 Enrollment ID: I20101021001272 |
| Provider Name | David I Schaffer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063687382 PECOS PAC ID: 2062548043 Enrollment ID: I20101022000922 |
| Provider Name | William Casey Conner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609068246 PECOS PAC ID: 7113111840 Enrollment ID: I20101027000237 |
| Provider Name | Bridgett Lowe Asbury |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679514319 PECOS PAC ID: 5597959262 Enrollment ID: I20101027000753 |
| Provider Name | Sandra Gail Brickman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376589556 PECOS PAC ID: 9436124641 Enrollment ID: I20101027000772 |
| Provider Name | Marcus C. Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699731026 PECOS PAC ID: 9032124334 Enrollment ID: I20101109000411 |
| Provider Name | Brent Alan Savelli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306878251 PECOS PAC ID: 1355437070 Enrollment ID: I20101115000777 |
| Provider Name | Emily R Copeland |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1932416252 PECOS PAC ID: 3577759489 Enrollment ID: I20101117001622 |
| Provider Name | Roslyn C Banks-jackson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134112618 PECOS PAC ID: 0547275976 Enrollment ID: I20101201000734 |
| Provider Name | Apurva N. Shah |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1174694137 PECOS PAC ID: 0749476703 Enrollment ID: I20101202000387 |
| Provider Name | Rubal Patel |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1952543274 PECOS PAC ID: 1658568092 Enrollment ID: I20101210000163 |
| Provider Name | Forte David Mceachin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194792929 PECOS PAC ID: 9436149341 Enrollment ID: I20101214000706 |
| Provider Name | Raymond G Moreno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154323103 PECOS PAC ID: 2163619354 Enrollment ID: I20101214000990 |
| Provider Name | Barbara Joslow |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982669503 PECOS PAC ID: 3678762515 Enrollment ID: I20110107000865 |
| Provider Name | George Yared |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790786226 PECOS PAC ID: 5395829030 Enrollment ID: I20110204000176 |
| Provider Name | John R Pawloski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093899981 PECOS PAC ID: 4688774813 Enrollment ID: I20110204000198 |
| Provider Name | Temitope Foster |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356538615 PECOS PAC ID: 8921025479 Enrollment ID: I20110209000931 |
| Provider Name | Jerri K Aultman |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1982908281 PECOS PAC ID: 8729269329 Enrollment ID: I20110301000905 |
| Provider Name | Chelsi L Tullos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538466883 PECOS PAC ID: 4789867334 Enrollment ID: I20110321000246 |
| Provider Name | Derek B Walker |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1982916532 PECOS PAC ID: 2860687019 Enrollment ID: I20110322000032 |
| Provider Name | Joe C Clifton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255417994 PECOS PAC ID: 5890693956 Enrollment ID: I20110524000099 |
| Provider Name | William Leslie Hornback |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871619130 PECOS PAC ID: 4789853102 Enrollment ID: I20110801000701 |
| Provider Name | Dustin L Russell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922260066 PECOS PAC ID: 7517136294 Enrollment ID: I20110815000523 |
| Provider Name | Laurie J Gautney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457547309 PECOS PAC ID: 9739279431 Enrollment ID: I20110908002201 |
| Provider Name | Michael J Wilkowski |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1790744373 PECOS PAC ID: 9537172184 Enrollment ID: I20110916000248 |
| Provider Name | Brandi M Holsey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962658104 PECOS PAC ID: 5294906368 Enrollment ID: I20110921000306 |
| Provider Name | Johnny J Stephens |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1093703738 PECOS PAC ID: 7012992258 Enrollment ID: I20110921000486 |
| Provider Name | Anthony Burke |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700906427 PECOS PAC ID: 1456427236 Enrollment ID: I20110927000562 |
| Provider Name | Brittney W. Berckman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114189230 PECOS PAC ID: 8921271149 Enrollment ID: I20111104000014 |
| Provider Name | Dawn M Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346539533 PECOS PAC ID: 4486829728 Enrollment ID: I20111214000805 |
| Provider Name | Thomas W Schoborg |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1386630358 PECOS PAC ID: 4789850306 Enrollment ID: I20120104000128 |
| Provider Name | Ali Saligheh Araghi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1114050457 PECOS PAC ID: 1951492701 Enrollment ID: I20120105000951 |
| Provider Name | Bret B Wagenhorst |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1841201134 PECOS PAC ID: 1850567231 Enrollment ID: I20120106000155 |
| Provider Name | Wesley Wallis Walker |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1134291727 PECOS PAC ID: 6305003641 Enrollment ID: I20120130000218 |
| Provider Name | Ronald Gary Adams |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922015254 PECOS PAC ID: 2365470754 Enrollment ID: I20120306000702 |
| Provider Name | Carl Allen Woods |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174550727 PECOS PAC ID: 6103803903 Enrollment ID: I20120322000168 |
| Provider Name | Dana M Burgio Adams |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1730447467 PECOS PAC ID: 6608038955 Enrollment ID: I20120502000289 |
| Provider Name | Lakesha A Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649542663 PECOS PAC ID: 5395908727 Enrollment ID: I20120523000295 |
| Provider Name | Laura S Sumner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750686507 PECOS PAC ID: 7214191758 Enrollment ID: I20120612000596 |
| Provider Name | Penny Heinrich |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1083804546 PECOS PAC ID: 3971668567 Enrollment ID: I20120619000279 |
| Provider Name | Heath J Parrish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932464542 PECOS PAC ID: 5294981916 Enrollment ID: I20120813000749 |
| Provider Name | Lashawn B Ealey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497010003 PECOS PAC ID: 1052568532 Enrollment ID: I20120906000362 |
| Provider Name | Pankaj H Chhatbar |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649442625 PECOS PAC ID: 2365611696 Enrollment ID: I20121029000159 |
| Provider Name | Justin M Fender |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164772372 PECOS PAC ID: 3678724044 Enrollment ID: I20121112000415 |
| Provider Name | Dawn Glisson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740531516 PECOS PAC ID: 0648421701 Enrollment ID: I20121119000406 |
| Provider Name | Ramona M. Cawley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578876900 PECOS PAC ID: 3173775244 Enrollment ID: I20121219000033 |
| Provider Name | Vincent G Valencia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134359243 PECOS PAC ID: 2860645611 Enrollment ID: I20130104000089 |
| Provider Name | Monica R Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184805822 PECOS PAC ID: 3870747298 Enrollment ID: I20130211000476 |
| Provider Name | Donna Galliano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043552334 PECOS PAC ID: 7416192802 Enrollment ID: I20130408000422 |
| Provider Name | Nicholas L Misulia |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760615413 PECOS PAC ID: 3476790676 Enrollment ID: I20130507000491 |
| Provider Name | Shannon L Price |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891718870 PECOS PAC ID: 4082803085 Enrollment ID: I20130624000480 |
| Provider Name | Marcia L Tankersly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194160283 PECOS PAC ID: 6800035718 Enrollment ID: I20130625000156 |
| Provider Name | Cheau Williams |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588982151 PECOS PAC ID: 7719171149 Enrollment ID: I20130627000282 |
| Provider Name | Flavia S Rossi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225354525 PECOS PAC ID: 7517107873 Enrollment ID: I20130709000774 |
| Provider Name | Allison L Presley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134561574 PECOS PAC ID: 6507009545 Enrollment ID: I20130823000729 |
| Provider Name | Kimberly D Massey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598197725 PECOS PAC ID: 2264675016 Enrollment ID: I20130827000781 |
| Provider Name | Paul T Cartwright |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932306149 PECOS PAC ID: 0446494249 Enrollment ID: I20130918000012 |
| Provider Name | Lindsey Coffee Mcclain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013217645 PECOS PAC ID: 5092959494 Enrollment ID: I20130925000856 |
| Provider Name | Vince Faridani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962645671 PECOS PAC ID: 3577798438 Enrollment ID: I20131030001337 |
| Provider Name | Jennifer L Howell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396018628 PECOS PAC ID: 1153557251 Enrollment ID: I20131120000465 |
| Provider Name | Justin Richard Allen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952545550 PECOS PAC ID: 8325275878 Enrollment ID: I20131209000989 |
| Provider Name | Jason M Allen |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1417387085 PECOS PAC ID: 4981831211 Enrollment ID: I20131212001152 |
| Provider Name | Keisha C Stevens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336120864 PECOS PAC ID: 2163473521 Enrollment ID: I20131216001118 |
| Provider Name | Abhay J Deshmukh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861726481 PECOS PAC ID: 6305087834 Enrollment ID: I20140506000387 |
| Provider Name | William Min |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1841495710 PECOS PAC ID: 4284759010 Enrollment ID: I20140610001343 |
| Provider Name | Brittany Thomas |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1194969733 PECOS PAC ID: 7315163409 Enrollment ID: I20140725001487 |
| 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 | Channing J Hampton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164714416 PECOS PAC ID: 2365661618 Enrollment ID: I20140918000407 |
| Provider Name | William Hsu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578854725 PECOS PAC ID: 1557583754 Enrollment ID: I20141103001792 |
| Provider Name | Gerlana S Vargas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295139673 PECOS PAC ID: 5991027815 Enrollment ID: I20141204000786 |
| Provider Name | Johnny Washington |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407007552 PECOS PAC ID: 7416271580 Enrollment ID: I20150120001302 |
| Provider Name | Linda Michelle Bixler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053715573 PECOS PAC ID: 0941525794 Enrollment ID: I20150219000693 |
| Provider Name | Joseph G Cheatham |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700948494 PECOS PAC ID: 2860517018 Enrollment ID: I20150313001162 |
| Provider Name | Caroline Perry Hendley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679962807 PECOS PAC ID: 3577880038 Enrollment ID: I20150320000695 |
| Provider Name | Kelly R Grummer-smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619310802 PECOS PAC ID: 7810214947 Enrollment ID: I20150327002540 |
| Provider Name | Stanley Soles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750790465 PECOS PAC ID: 3779800834 Enrollment ID: I20150330001084 |
| Provider Name | Deidre C Peacock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982094298 PECOS PAC ID: 1052638129 Enrollment ID: I20150330001449 |
| Provider Name | Israel Saucedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003222191 PECOS PAC ID: 7719205541 Enrollment ID: I20150407002204 |
| Provider Name | Edan Y Shapiro |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1407090459 PECOS PAC ID: 5496066433 Enrollment ID: I20150617003139 |
| Provider Name | Langston B Cleveland |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1790857381 PECOS PAC ID: 8022329788 Enrollment ID: I20150622001788 |
| Provider Name | Haiden H Edore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306232491 PECOS PAC ID: 0345552618 Enrollment ID: I20150630001531 |
| Provider Name | Emily Anne Quinn |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1497011712 PECOS PAC ID: 9931345220 Enrollment ID: I20150707002394 |
| Provider Name | Stephanie A Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184014425 PECOS PAC ID: 0941516710 Enrollment ID: I20150825004684 |
| Provider Name | Rianot T Amzat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982979373 PECOS PAC ID: 4789990391 Enrollment ID: I20150827001434 |
| Provider Name | Timothy B. Harris |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619358652 PECOS PAC ID: 4183930506 Enrollment ID: I20150831003088 |
| Provider Name | Laura L Callaway |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1376970103 PECOS PAC ID: 2567781289 Enrollment ID: I20150901000426 |
| Provider Name | John H Woodruff |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063655769 PECOS PAC ID: 8123274743 Enrollment ID: I20150917001251 |
| Provider Name | Abhinav Saxena |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720378714 PECOS PAC ID: 7719296672 Enrollment ID: I20151016001203 |
| Provider Name | Catherine G Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861864050 PECOS PAC ID: 0244540185 Enrollment ID: I20151105001492 |
| Provider Name | Kemaya L Wilburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841675667 PECOS PAC ID: 3779893052 Enrollment ID: I20151117002461 |
| Provider Name | Linsey B Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831566462 PECOS PAC ID: 6800196148 Enrollment ID: I20151118001967 |
| Provider Name | Danika Curley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982865010 PECOS PAC ID: 1153574397 Enrollment ID: I20151215002322 |
| Provider Name | Dokun Tobi Dairo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508017906 PECOS PAC ID: 1850556309 Enrollment ID: I20151222001360 |
| Provider Name | Glenn S Avidon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124138292 PECOS PAC ID: 1153225818 Enrollment ID: I20151230000652 |
| Provider Name | Qiheng J Shen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437134756 PECOS PAC ID: 9739105651 Enrollment ID: I20160104001285 |
| Provider Name | Chinonye Uzaoamaka Nwoke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245662139 PECOS PAC ID: 9234432089 Enrollment ID: I20160128000800 |
| Provider Name | Dorothy Dee Agyepong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821214909 PECOS PAC ID: 9335444611 Enrollment ID: I20160224001710 |
| Provider Name | Justin M Stark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093087579 PECOS PAC ID: 8729217336 Enrollment ID: I20160302000949 |
| Provider Name | Anna Paulk Driggers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154788446 PECOS PAC ID: 8921304288 Enrollment ID: I20160311001674 |
| Provider Name | Brandy Carr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427418474 PECOS PAC ID: 6305143264 Enrollment ID: I20160321002506 |
| Provider Name | Jessica Parrish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164886545 PECOS PAC ID: 8123327400 Enrollment ID: I20160509001876 |
| Provider Name | Joseph Seagraves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992159503 PECOS PAC ID: 9234428053 Enrollment ID: I20160518001536 |
| Provider Name | Cori H Norman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1669836987 PECOS PAC ID: 8224328075 Enrollment ID: I20160607000550 |
| Provider Name | Deborah Cynthia Stokes |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538146956 PECOS PAC ID: 6204969660 Enrollment ID: I20160712001939 |
| Provider Name | Michael B Monahan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1114213428 PECOS PAC ID: 9234421066 Enrollment ID: I20160714000911 |
| Provider Name | Lindsey Shea M Mccranie Seagraves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235588518 PECOS PAC ID: 4486947322 Enrollment ID: I20160729000684 |
| Provider Name | Ana Margarita Margarita Hernandez Silen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871752907 PECOS PAC ID: 2365635125 Enrollment ID: I20160803000543 |
| Provider Name | Nora A Fine |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619996782 PECOS PAC ID: 5890694319 Enrollment ID: I20160805002031 |
| Provider Name | Amanda Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669724647 PECOS PAC ID: 4284929191 Enrollment ID: I20160816003012 |
| Provider Name | Karen Ashley Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386198869 PECOS PAC ID: 0042506719 Enrollment ID: I20160906001760 |
| Provider Name | Christie Long Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316390339 PECOS PAC ID: 3577850155 Enrollment ID: I20160926000855 |
| Provider Name | Tresa Lanelle Nesbitt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609154483 PECOS PAC ID: 9638499817 Enrollment ID: I20161025001077 |
| Provider Name | Jan H Westerman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1285674150 PECOS PAC ID: 3274510524 Enrollment ID: I20161101001150 |
| Provider Name | Alexia M Tanner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770967317 PECOS PAC ID: 4789966383 Enrollment ID: I20170113002382 |
| Provider Name | Kenneth Lindsey Kiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609230069 PECOS PAC ID: 0446532949 Enrollment ID: I20170118000482 |
| Provider Name | Bridgette C Harper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922543024 PECOS PAC ID: 6204119431 Enrollment ID: I20170213001726 |
| Provider Name | Ta Ressa Kenyetta Wills |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245553486 PECOS PAC ID: 1557593621 Enrollment ID: I20170228002066 |
| Provider Name | Christopher Allen Pate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740736263 PECOS PAC ID: 3476838962 Enrollment ID: I20170324000223 |
| Provider Name | Stewart Drew Warren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003109554 PECOS PAC ID: 3476778887 Enrollment ID: I20170418000895 |
| Provider Name | Angela Lynn Vannortwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083148092 PECOS PAC ID: 3870870397 Enrollment ID: I20170509003012 |
| Provider Name | Walter C Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457898249 PECOS PAC ID: 5890062830 Enrollment ID: I20170524000080 |
| Provider Name | Richard James Pearson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326484429 PECOS PAC ID: 4981993185 Enrollment ID: I20170620002797 |
| Provider Name | Alisha Davis Holloway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992230023 PECOS PAC ID: 5294004016 Enrollment ID: I20170710002117 |
| Provider Name | Brent William Acker |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407147028 PECOS PAC ID: 8628290806 Enrollment ID: I20170721000235 |
| Provider Name | Abduljalil Elfasi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1154685550 PECOS PAC ID: 5799055539 Enrollment ID: I20170726003703 |
| Provider Name | Christopher David Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720508567 PECOS PAC ID: 4587935929 Enrollment ID: I20170803002520 |
| Provider Name | Kyle E Fleck |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184914319 PECOS PAC ID: 1052632965 Enrollment ID: I20170829004062 |
| Provider Name | Anna D Money |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578968467 PECOS PAC ID: 5395019822 Enrollment ID: I20170922001002 |
| Provider Name | Sridhar Rajamani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1073576005 PECOS PAC ID: 8628047453 Enrollment ID: I20171017003637 |
| Provider Name | James Christian Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417467101 PECOS PAC ID: 9032477302 Enrollment ID: I20171213003011 |
| Provider Name | Richard L Jacobs |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427132588 PECOS PAC ID: 0840373585 Enrollment ID: I20171215002131 |
| Provider Name | Joshua Clifton Pridemore |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1417401977 PECOS PAC ID: 2365702941 Enrollment ID: I20180130000545 |
| Provider Name | Jessica Ann Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801301627 PECOS PAC ID: 7416217666 Enrollment ID: I20180207001927 |
| Provider Name | Srikrishna Vulava |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821301367 PECOS PAC ID: 7517108889 Enrollment ID: I20180417000372 |
| Provider Name | Ravali Tarigopula |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285802892 PECOS PAC ID: 0547427346 Enrollment ID: I20180620003054 |
| Provider Name | Frankie Hurst |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063950954 PECOS PAC ID: 9931484656 Enrollment ID: I20180806002880 |
| Provider Name | Kathryn Fulghum |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598290041 PECOS PAC ID: 8921359787 Enrollment ID: I20180918004179 |
| Provider Name | Clayton Ross Tapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760969018 PECOS PAC ID: 4486906088 Enrollment ID: I20181009003626 |
| Provider Name | Megan Robbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699156125 PECOS PAC ID: 2961754361 Enrollment ID: I20181012001917 |
| Provider Name | Kaitlyn Leigh Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821584855 PECOS PAC ID: 0446503023 Enrollment ID: I20181029001896 |
| Provider Name | Richard L Nutt |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1821070293 PECOS PAC ID: 8123038452 Enrollment ID: I20181112000865 |
| Provider Name | Celestine Amuchie Nnaeto |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1255562567 PECOS PAC ID: 8527283803 Enrollment ID: I20181205002622 |
| Provider Name | Martha Gibbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376027722 PECOS PAC ID: 8022353580 Enrollment ID: I20190102003206 |
| Provider Name | Lindsay Peavy Drew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679043830 PECOS PAC ID: 1355688938 Enrollment ID: I20190122001415 |
| Provider Name | Shelley S Colwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174095434 PECOS PAC ID: 1557600228 Enrollment ID: I20190226000127 |
| Provider Name | Pat Olivas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346723731 PECOS PAC ID: 3375882913 Enrollment ID: I20190226003511 |
| Provider Name | Radhwan Al Rubaye |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598149833 PECOS PAC ID: 4082953211 Enrollment ID: I20190305001658 |
| Provider Name | Emma Cummins Waldrop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154886745 PECOS PAC ID: 4486994712 Enrollment ID: I20190322000680 |
| Provider Name | Radha J Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285190918 PECOS PAC ID: 6800137621 Enrollment ID: I20190404001197 |
| Provider Name | Hedayah Scoon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962866392 PECOS PAC ID: 2062706286 Enrollment ID: I20190529002534 |
| Provider Name | John Hyatt |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881626091 PECOS PAC ID: 6002887379 Enrollment ID: I20190618003781 |
| Provider Name | Lindsey Durden Fletcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255992558 PECOS PAC ID: 2567799927 Enrollment ID: I20190807002348 |
| Provider Name | Nancy Caroline Roe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124680673 PECOS PAC ID: 9739417023 Enrollment ID: I20190823003030 |
| Provider Name | Lori Marie White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184277717 PECOS PAC ID: 8224367057 Enrollment ID: I20190904001945 |
| Provider Name | Erin E Payne |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1215955778 PECOS PAC ID: 0042218083 Enrollment ID: I20190904002433 |
| Provider Name | Sandra Melinda Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326694852 PECOS PAC ID: 7416287909 Enrollment ID: I20190926000419 |
| Provider Name | Nicholas Justin Webster |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619322328 PECOS PAC ID: 5890025902 Enrollment ID: I20191002001604 |
| Provider Name | Michael Paul O'brien |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720455892 PECOS PAC ID: 2264749381 Enrollment ID: I20191010000960 |
| Provider Name | Randi Tatum |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083062160 PECOS PAC ID: 0840521068 Enrollment ID: I20191018001393 |
| Provider Name | Praveen K Vemula |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891958922 PECOS PAC ID: 5395923759 Enrollment ID: I20191018001561 |
| Provider Name | Emily Roxanne Hawsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013563733 PECOS PAC ID: 7012249857 Enrollment ID: I20191029001959 |
| Provider Name | Anand Subhash Shah |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073870358 PECOS PAC ID: 4880940022 Enrollment ID: I20191114003114 |
| Provider Name | Josephine U Anuforo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1366898330 PECOS PAC ID: 5597190322 Enrollment ID: I20200123003171 |
| Provider Name | Eric Aurelio Ordinario |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1871545301 PECOS PAC ID: 0042360901 Enrollment ID: I20200217004100 |
| Provider Name | Justin Giddens |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558992479 PECOS PAC ID: 3779911011 Enrollment ID: I20200319001133 |
| Provider Name | Terry Mueller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891849691 PECOS PAC ID: 3476631060 Enrollment ID: I20200321000296 |
| Provider Name | Carroll Davis Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982111704 PECOS PAC ID: 0547698508 Enrollment ID: I20200325002168 |
| Provider Name | Larry Lee Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225665946 PECOS PAC ID: 7315376092 Enrollment ID: I20200331003266 |
| Provider Name | Elise Adele Walker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083050595 PECOS PAC ID: 0042505703 Enrollment ID: I20200409003252 |
| Provider Name | Eberechukwu Mosieri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851775605 PECOS PAC ID: 8123457272 Enrollment ID: I20200410001914 |
| Provider Name | Robin B Dillard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871740324 PECOS PAC ID: 6709813330 Enrollment ID: I20200420000994 |
| Provider Name | Donald D Menya |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194068601 PECOS PAC ID: 5193966612 Enrollment ID: I20200423001053 |
| Provider Name | Kristy P Daniels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891040051 PECOS PAC ID: 5092146258 Enrollment ID: I20200504001994 |
| Provider Name | Mary Y Truitt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093129975 PECOS PAC ID: 8022312719 Enrollment ID: I20200504002878 |
| Provider Name | Vinay Garlapati |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508271206 PECOS PAC ID: 5294092771 Enrollment ID: I20200604001680 |
| Provider Name | Fares Hakim |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841383304 PECOS PAC ID: 9830119742 Enrollment ID: I20200608000697 |
| Provider Name | Timothy Fuller |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1104153063 PECOS PAC ID: 5092137224 Enrollment ID: I20200617000951 |
| Provider Name | Meng-jun Xiong |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1285053173 PECOS PAC ID: 8224257845 Enrollment ID: I20200622002009 |
| Provider Name | Abeeku Ayize Ricks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205368222 PECOS PAC ID: 1759705031 Enrollment ID: I20200720002031 |
| Provider Name | Tewodros Alemu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972039998 PECOS PAC ID: 4284908286 Enrollment ID: I20200804000604 |
| Provider Name | Peter Alexander Mcnally |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1164785721 PECOS PAC ID: 5597180596 Enrollment ID: I20200807002266 |
| Provider Name | Christopher Lee Gravitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083223853 PECOS PAC ID: 4688090160 Enrollment ID: I20200813003694 |
| Provider Name | Zeyad Morcos |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235115361 PECOS PAC ID: 1456323070 Enrollment ID: I20200903000101 |
| Provider Name | Matthew Nijem Varn |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316370851 PECOS PAC ID: 1951652403 Enrollment ID: I20200909000846 |
| Provider Name | Anna V Wright |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1437763794 PECOS PAC ID: 4385062744 Enrollment ID: I20200916002124 |
| Provider Name | Deanna M Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073125159 PECOS PAC ID: 9830517119 Enrollment ID: I20200918000503 |
| Provider Name | Nchang Taka |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700147238 PECOS PAC ID: 3678853231 Enrollment ID: I20200930002529 |
| Provider Name | Lucas Jon Policastro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013442177 PECOS PAC ID: 1951720184 Enrollment ID: I20201007001749 |
| Provider Name | Hillary Midler |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1750895082 PECOS PAC ID: 3274953799 Enrollment ID: I20201021001780 |
| Provider Name | Amber Guyton |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1306236930 PECOS PAC ID: 3779993639 Enrollment ID: I20201104000196 |
| Provider Name | Kenneth Trevor Shealy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104436922 PECOS PAC ID: 7618388570 Enrollment ID: I20201124003123 |
| Provider Name | Rana M Adeel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528435724 PECOS PAC ID: 7214227479 Enrollment ID: I20201130003113 |
| Provider Name | Marcum Quinn |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1386621217 PECOS PAC ID: 2860686888 Enrollment ID: I20201215003083 |
| Provider Name | Satish V Ravi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417024183 PECOS PAC ID: 1355612466 Enrollment ID: I20201228001050 |
| Provider Name | Ashley Taylor West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235731654 PECOS PAC ID: 0547673485 Enrollment ID: I20210113001866 |
| Provider Name | Preston Glenn Thornhill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063039865 PECOS PAC ID: 1557775194 Enrollment ID: I20210122001070 |
| Provider Name | Pujan Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497286363 PECOS PAC ID: 5698045557 Enrollment ID: I20210203000279 |
| Provider Name | Boyi Gao |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497008205 PECOS PAC ID: 2769778018 Enrollment ID: I20210216001680 |
| Provider Name | Dwight Edward Hooper |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871564096 PECOS PAC ID: 8325099336 Enrollment ID: I20210325002025 |
| Provider Name | Tarek Bakdash |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871545921 PECOS PAC ID: 2163400953 Enrollment ID: I20210407002407 |
| Provider Name | Tracy Taggart |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962603530 PECOS PAC ID: 8325121965 Enrollment ID: I20210412002137 |
| Provider Name | Eliran Bracha |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1538513726 PECOS PAC ID: 1759651581 Enrollment ID: I20210419001696 |
| Provider Name | Hali Mallard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053990788 PECOS PAC ID: 8123436581 Enrollment ID: I20210423000846 |
| Provider Name | Angel Miguel Valdes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881274595 PECOS PAC ID: 6204245301 Enrollment ID: I20210430001606 |
| Provider Name | Luanne Ashton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669078747 PECOS PAC ID: 2860801925 Enrollment ID: I20210503001139 |
| Provider Name | Melissa Vickery |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982295820 PECOS PAC ID: 2163838178 Enrollment ID: I20210526000538 |
| Provider Name | Robert Jeter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366929598 PECOS PAC ID: 1153720636 Enrollment ID: I20210603002015 |
| Provider Name | Kasey Graham Mays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083288666 PECOS PAC ID: 7416357033 Enrollment ID: I20210617002508 |
| Provider Name | Sitarama Arvind Varma Mudunuru |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1952753253 PECOS PAC ID: 0941537054 Enrollment ID: I20210617002922 |
| Provider Name | Clinton Matthew Cawley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982050639 PECOS PAC ID: 7113327784 Enrollment ID: I20210618000799 |
| Provider Name | Ngozi E Okanu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376049072 PECOS PAC ID: 3678974698 Enrollment ID: I20210629000957 |
| Provider Name | Nelia F Mims |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1023692290 PECOS PAC ID: 1951703016 Enrollment ID: I20210712002986 |
| Provider Name | Eric Daniel Webb |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912351255 PECOS PAC ID: 0547550451 Enrollment ID: I20210714003116 |
| Provider Name | Janae E Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669978037 PECOS PAC ID: 0143623561 Enrollment ID: I20210722003403 |
| Provider Name | Katie M Hudgens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376076505 PECOS PAC ID: 1850667254 Enrollment ID: I20210726001291 |
| Provider Name | Edward Flores |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912922386 PECOS PAC ID: 8224095203 Enrollment ID: I20210729003479 |
| Provider Name | Rita Perez Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508450461 PECOS PAC ID: 2365846383 Enrollment ID: I20210812000472 |
| Provider Name | Andrew Nackashi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821449059 PECOS PAC ID: 4880989524 Enrollment ID: I20210813000984 |
| Provider Name | Vincent D Wright |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609228196 PECOS PAC ID: 8022393644 Enrollment ID: I20210818003768 |
| Provider Name | Adeleke Adebiyi Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225087638 PECOS PAC ID: 2567459829 Enrollment ID: I20210823000364 |
| Provider Name | Pardeep Singh Taunk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336643477 PECOS PAC ID: 6608270699 Enrollment ID: I20210827001061 |
| Provider Name | Meron Abraham Tesfay |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356603914 PECOS PAC ID: 4981906369 Enrollment ID: I20210903001176 |
| Provider Name | Andrea Nicole Durden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952078024 PECOS PAC ID: 9234535964 Enrollment ID: I20210903002803 |
| Provider Name | Neslyne B Augustin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245729631 PECOS PAC ID: 4789080045 Enrollment ID: I20210913000214 |
| Provider Name | Mary Anne Knox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225707888 PECOS PAC ID: 3870999022 Enrollment ID: I20210914000418 |
| Provider Name | Logan Balkcom |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1891457768 PECOS PAC ID: 7517365018 Enrollment ID: I20211014000554 |
| Provider Name | Melissa Michelle Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588328454 PECOS PAC ID: 9931598208 Enrollment ID: I20211109000568 |
| Provider Name | Marius Laurinaitis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639174212 PECOS PAC ID: 2163439431 Enrollment ID: I20211112002608 |
| Provider Name | Sumeet Kumar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861649527 PECOS PAC ID: 4688710403 Enrollment ID: I20211116001792 |
| Provider Name | Aaron-nickolaos Zervos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174086110 PECOS PAC ID: 8921498890 Enrollment ID: I20211208001277 |
| Provider Name | Joseph Sonntag |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063038388 PECOS PAC ID: 8325439938 Enrollment ID: I20211215000964 |
| Provider Name | Jabulani Sidile |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164650743 PECOS PAC ID: 9830312842 Enrollment ID: I20220106001158 |
| Provider Name | Sudeep H Ruparelia |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265817001 PECOS PAC ID: 9739480799 Enrollment ID: I20220204000678 |
| Provider Name | Rodrick Maurice Turner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295227619 PECOS PAC ID: 4486901543 Enrollment ID: I20220214001164 |
| Provider Name | Mohammed Sharif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104321082 PECOS PAC ID: 7810394343 Enrollment ID: I20220228000321 |
| Provider Name | Laura Elizabeth Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417621475 PECOS PAC ID: 5597159533 Enrollment ID: I20220308001780 |
| Provider Name | Deborah Harvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255074456 PECOS PAC ID: 5799172656 Enrollment ID: I20220422000792 |
| Provider Name | Neil Gayle Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760917983 PECOS PAC ID: 7315343035 Enrollment ID: I20220426001698 |
| Provider Name | Sirisha Perumandla |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700891454 PECOS PAC ID: 1759386121 Enrollment ID: I20220518000607 |
| Provider Name | Frank S Melograna |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1528050895 PECOS PAC ID: 0345297412 Enrollment ID: I20220523002135 |
| Provider Name | Kim Levette Johnson-barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295300754 PECOS PAC ID: 3375921430 Enrollment ID: I20220601001295 |
| Provider Name | Nagasasikanth Mopuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205399805 PECOS PAC ID: 2668875535 Enrollment ID: I20220606000862 |
| Provider Name | Ian Michael Hester |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1861710089 PECOS PAC ID: 9234324013 Enrollment ID: I20220608003119 |
| Provider Name | Catherine R Ross |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1205298346 PECOS PAC ID: 3577942705 Enrollment ID: I20220618000438 |
| Provider Name | Lauren Krasner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093771941 PECOS PAC ID: 8527964238 Enrollment ID: I20220712002160 |
| Provider Name | Nicole Oberfoell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083141683 PECOS PAC ID: 5597035089 Enrollment ID: I20220719001695 |
| Provider Name | Rachel Horn |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457844367 PECOS PAC ID: 4688921893 Enrollment ID: I20220721002286 |
| Provider Name | Richard Sterling Haring |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1811429558 PECOS PAC ID: 3476823139 Enrollment ID: I20220802000269 |
| Provider Name | Gehan Botrus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275910911 PECOS PAC ID: 9537415625 Enrollment ID: I20220803001861 |
| Provider Name | Stephen Anthony James |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497218192 PECOS PAC ID: 4284016221 Enrollment ID: I20220808000636 |
| Provider Name | Carley Rae Kinard |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1376130112 PECOS PAC ID: 6901289206 Enrollment ID: I20220819000605 |
| Provider Name | Linda L Mcintire |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1063481919 PECOS PAC ID: 6608807896 Enrollment ID: I20220907003720 |
| Provider Name | Marlee Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700508272 PECOS PAC ID: 8325424013 Enrollment ID: I20221004001328 |
| Provider Name | Hironobu Takeda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164929568 PECOS PAC ID: 8921332750 Enrollment ID: I20221014000206 |
| Provider Name | Kristin A Yates Coleman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518222330 PECOS PAC ID: 3375849979 Enrollment ID: I20221014001660 |
| Provider Name | Manuel Chavez |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1619690344 PECOS PAC ID: 5496121386 Enrollment ID: I20221018001567 |
| Provider Name | Christopher Mattson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427051739 PECOS PAC ID: 4284876079 Enrollment ID: I20221025001695 |
| Provider Name | Alison Lindsey Fitzgerald |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1568991750 PECOS PAC ID: 6800265745 Enrollment ID: I20221215000547 |
| Provider Name | Brent Jospeh Robison |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386369882 PECOS PAC ID: 0042682098 Enrollment ID: I20230221001195 |
| Provider Name | Callie Haynes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003527714 PECOS PAC ID: 9335513902 Enrollment ID: I20230322000417 |
| Provider Name | Gary Jonathan Myrthil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649835125 PECOS PAC ID: 3072848688 Enrollment ID: I20230619000600 |
| Provider Name | Waseem Obeid |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1457733297 PECOS PAC ID: 2769773456 Enrollment ID: I20230622002548 |
| Provider Name | Hansley Bobo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689202517 PECOS PAC ID: 3173983384 Enrollment ID: I20230720000224 |
| Provider Name | Nicholas Alexander Arnold |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497383293 PECOS PAC ID: 2567822471 Enrollment ID: I20230724001450 |
| Provider Name | Sahithi Chittamuri |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1083147623 PECOS PAC ID: 5092177089 Enrollment ID: I20230808001217 |
| Provider Name | Hiroki Komoto |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1952796492 PECOS PAC ID: 4183920598 Enrollment ID: I20230809001296 |
| Provider Name | Samantha Denise Broadwater |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568032274 PECOS PAC ID: 3779945472 Enrollment ID: I20230811002587 |
| Provider Name | Jordan Lee Godbey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689092330 PECOS PAC ID: 8527334747 Enrollment ID: I20230828003200 |
| Provider Name | Britney Michelle Wyatt |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942083746 PECOS PAC ID: 4587028493 Enrollment ID: I20230911004105 |
| Provider Name | Beth Hendley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205519329 PECOS PAC ID: 0345694451 Enrollment ID: I20230922003002 |
| Provider Name | Kimberley Whitley Rodgers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629856075 PECOS PAC ID: 9032564414 Enrollment ID: I20231005001636 |
| Provider Name | Oladipo Fadayomi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316383565 PECOS PAC ID: 8820391634 Enrollment ID: I20231009001786 |
| Provider Name | Rachel Ware Holloway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013695923 PECOS PAC ID: 9133574254 Enrollment ID: I20231010002188 |
| Provider Name | Kristin Gaffney |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720241318 PECOS PAC ID: 2163556523 Enrollment ID: I20231103001128 |
| Provider Name | Chelsey Coneway |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821776394 PECOS PAC ID: 1951758994 Enrollment ID: I20231113001367 |
| Provider Name | Michelle Lynn Shifflett |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1073034732 PECOS PAC ID: 3577836501 Enrollment ID: I20231122001417 |
| Provider Name | Kanan Hamed Hudhud |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1528069226 PECOS PAC ID: 3678465135 Enrollment ID: I20231213000343 |
| Provider Name | Devendra T Shantha |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1346237013 PECOS PAC ID: 7911086137 Enrollment ID: I20240105002294 |
| Provider Name | Brianna Emadi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154191039 PECOS PAC ID: 2567814742 Enrollment ID: I20240124000298 |
| Provider Name | Mark Stuckey |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265475263 PECOS PAC ID: 4284547779 Enrollment ID: I20240131001039 |
| Provider Name | Clinton Medbery |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1609873421 PECOS PAC ID: 2860480019 Enrollment ID: I20240220000108 |
| Provider Name | Daniel L Boatright |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568230829 PECOS PAC ID: 1557707643 Enrollment ID: I20240312000874 |
| Provider Name | James Stansbury |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548267149 PECOS PAC ID: 1951202266 Enrollment ID: I20240314001967 |
| Provider Name | Xavier Capalla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417523093 PECOS PAC ID: 7719325364 Enrollment ID: I20240402003465 |
| Provider Name | Kevin Smith |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1205898137 PECOS PAC ID: 8820089337 Enrollment ID: I20240410001138 |
| Provider Name | Hannah Janleigh Vickers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013503002 PECOS PAC ID: 3678015930 Enrollment ID: I20240603001665 |
| Provider Name | Cynthia Foster |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1902229248 PECOS PAC ID: 0345782439 Enrollment ID: I20240604003200 |
| Provider Name | Brisandi Villar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912587551 PECOS PAC ID: 9739622911 Enrollment ID: I20240617000232 |
| Provider Name | Leo Enrique Larios |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154907517 PECOS PAC ID: 7810430337 Enrollment ID: I20240625000630 |
| Provider Name | Shakyra Lashon Robinson-prince |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1508641853 PECOS PAC ID: 1658815725 Enrollment ID: I20240701000058 |
| Provider Name | Summer Alvarez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053999458 PECOS PAC ID: 6608220603 Enrollment ID: I20240715002688 |
| Provider Name | Catherine Rae Cravey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275111312 PECOS PAC ID: 4981149606 Enrollment ID: I20240717001929 |
| Provider Name | Raymond Alvarez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063090462 PECOS PAC ID: 7719422401 Enrollment ID: I20240717004886 |
| Provider Name | Wayne Darisaw |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619530276 PECOS PAC ID: 9638404320 Enrollment ID: I20240725004414 |
| Provider Name | Sanjay Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942876438 PECOS PAC ID: 6305241985 Enrollment ID: I20240726000248 |
| Provider Name | Jermonte Lowe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740743350 PECOS PAC ID: 7810434263 Enrollment ID: I20240802000520 |
| Provider Name | Parisa Abraham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275129744 PECOS PAC ID: 6709273667 Enrollment ID: I20240813004365 |
| Provider Name | Suzana Kely Rocha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871160382 PECOS PAC ID: 9638572258 Enrollment ID: I20240910001416 |
| Provider Name | Zoye Griffin Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952146201 PECOS PAC ID: 2365973740 Enrollment ID: I20241009003511 |
| Provider Name | Jacob Warren Walker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578397055 PECOS PAC ID: 3971036476 Enrollment ID: I20241022004991 |
| Provider Name | Vanpraseuth Fongnaly |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265574461 PECOS PAC ID: 7315092061 Enrollment ID: I20241024000199 |
| Provider Name | Theodore Rothman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154332005 PECOS PAC ID: 4789677154 Enrollment ID: I20241029004323 |
| Provider Name | Kalvin Abraham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730767989 PECOS PAC ID: 7416338538 Enrollment ID: I20241107003802 |
| Provider Name | Peter Tran |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1891864203 PECOS PAC ID: 4284854894 Enrollment ID: I20241108000677 |
Tifton Family Medicine, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 902 18th St East, Tifton, GA 31794 Phone: 229-382-6414 | |
Gowdy Enterprises Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2406 Tift Ave N, Suite 202, Tifton, GA 31794 Phone: 770-355-2064 Fax: 229-238-3940 | |
Allhealth Choice, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 242 2nd St E Ste B, Tifton, GA 31794 Phone: 404-996-0086 | |