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14 Hospital Rd Newnan GA 30263-1201 | |
| (770) 400-5660 | |
| (770) 400-5799 |
| Full Name | |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 14 Hospital Rd, Newnan, Georgia |
| Authorized Official Name and Position | Casey Tarpley (PRESIDENT) |
| Authorized Official Contact | 7702531121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
14 Hospital Rd Newnan GA 30263-1201 Ph: (770) 400-5660 | 14 Hospital Rd Newnan GA 30263-1201 Ph: (770) 400-5660 |
| NPI Number | 1386385193 |
|---|---|
| Provider Enumeration Date | 04/05/2022 |
| Last Update Date | 12/17/2024 |
| Medicare PECOS PAC ID | 1951846419 |
|---|---|
| Medicare Enrollment ID | O20240709004138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386385193 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Marlo P Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326259243 PECOS PAC ID: 5193816114 Enrollment ID: I20070806000593 |
| Provider Name | Samantha Jo Fikes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710611967 PECOS PAC ID: 7214476274 Enrollment ID: I20240822002146 |
| Provider Name | Tracy Lynn Behm |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861419822 PECOS PAC ID: 1658381538 Enrollment ID: I20240912000857 |
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