| Valdosta Medical Clinic | |
|
3207 Country Club Dr Valdosta GA 31605-1029 | |
| (229) 242-8480 | |
| (229) 241-0252 |
| Full Name | Valdosta Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 3207 Country Club Dr, Valdosta, Georgia |
| Authorized Official Name and Position | Robin Bush (MANAGER) |
| Authorized Official Contact | 2292428480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valdosta Medical Clinic 3207 Country Club Dr. Valdosta GA 31605 Ph: (229) 242-8480 | Valdosta Medical Clinic 3207 Country Club Dr Valdosta GA 31605-1029 Ph: (229) 242-8480 |
| NPI Number | 1538200035 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 01/29/2015 |
| Medicare PECOS PAC ID | 9234197286 |
|---|---|
| Medicare Enrollment ID | O20041222000501 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538200035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Fredrick A Koehler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255327797 PECOS PAC ID: 9931001039 Enrollment ID: I20041111000344 |
| Provider Name | Kesavan G Kumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124016860 PECOS PAC ID: 0143288175 Enrollment ID: I20041222000437 |
| Provider Name | Edward J Fricker |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316933823 PECOS PAC ID: 5193773406 Enrollment ID: I20050104000215 |
| Provider Name | Thomas W Hobby |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497749733 PECOS PAC ID: 5092763318 Enrollment ID: I20050104000332 |
| Provider Name | Alford T Brady |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467449272 PECOS PAC ID: 8628026960 Enrollment ID: I20050104000504 |
| Provider Name | George E Powell |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1821072398 PECOS PAC ID: 7113975129 Enrollment ID: I20050106000459 |
| Provider Name | Glenn H Evans |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285623744 PECOS PAC ID: 1759339781 Enrollment ID: I20050106000622 |
| Provider Name | Hernando Moreno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396950994 PECOS PAC ID: 0840390944 Enrollment ID: I20070702000498 |
| 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 | Bonni Cohen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861535296 PECOS PAC ID: 6901902923 Enrollment ID: I20100521000310 |
| Provider Name | Jonathan L Underwood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265612972 PECOS PAC ID: 6406040005 Enrollment ID: I20101027001264 |
| Provider Name | Jarod F Bailey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649432733 PECOS PAC ID: 4688842198 Enrollment ID: I20110727000221 |
| Provider Name | Mary Alyson Lerstang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851653091 PECOS PAC ID: 3779732383 Enrollment ID: I20120925000533 |
| Provider Name | Susan B Howell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518396795 PECOS PAC ID: 3971723230 Enrollment ID: I20141008001981 |
| Provider Name | Anthony Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104186246 PECOS PAC ID: 4880850692 Enrollment ID: I20151102000983 |
Joseph S Thomas M D Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Connell Rd, Ste T, Valdosta, GA 31602 Phone: 229-242-9565 Fax: 229-242-1725 | |
Care Medical Center Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2804 N Oak St, Suite C, Valdosta, GA 31602 Phone: 229-241-8925 Fax: 229-241-7672 | |
Griner Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3301 N Oak Street Ext, Valdosta, GA 31605 Phone: 229-242-6061 Fax: 229-242-6151 | |
Valdosta Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3300 Greystone Way, Valdosta, GA 31605 Phone: 229-247-7700 | |
Valdosta Gastroenterology Associates, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 410 Connell Rd, Valdosta, GA 31602 Phone: 229-244-1570 Fax: 229-247-1084 | |
Partnership Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 Griffin Ave, Valdosta, GA 31601 Phone: 229-245-0020 Fax: 229-245-9855 | |
Bennett P Hogan Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 117 W Northside Dr, Valdosta, GA 31602 Phone: 229-333-0616 Fax: 229-333-0647 |