| Vidalia Immediate & Primary Care Llc | |
|
122 Alice Coleman Drive Vidalia GA 30474 | |
| (912) 805-2273 | |
| Not Available |
| Full Name | Vidalia Immediate & Primary Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 122 Alice Coleman Drive, Vidalia, Georgia |
| Authorized Official Name and Position | Melissa Ann Beckum (PRACTICE MANAGER/OFFICE MANAGER) |
| Authorized Official Contact | 9122932869 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vidalia Immediate & Primary Care Llc Po Box 2324 Vidalia GA 30475-2324 Ph: (912) 805-2273 | Vidalia Immediate & Primary Care Llc 122 Alice Coleman Drive Vidalia GA 30474 Ph: (912) 805-2273 |
| NPI Number | 1942974167 |
|---|---|
| Provider Enumeration Date | 08/02/2021 |
| Last Update Date | 11/16/2021 |
| Medicare PECOS PAC ID | 8820489941 |
|---|---|
| Medicare Enrollment ID | O20211229000187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942974167 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Joseph Gerard Foust |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407837438 PECOS PAC ID: 0749177079 Enrollment ID: I20040618000861 |
| Provider Name | Ian Christopher Munger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023247723 PECOS PAC ID: 0042344855 Enrollment ID: I20131112001738 |
| Provider Name | Dewey Howell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467808279 PECOS PAC ID: 2668767583 Enrollment ID: I20160817000508 |
| Provider Name | Alexis Byrd Fountain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821724386 PECOS PAC ID: 5496121774 Enrollment ID: I20221012002264 |
Vidalia Internal Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 210 Mose Coleman Dr, Vidalia, GA 30474 Phone: 912-537-2200 Fax: 912-537-2260 | |
Wheeler County Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Maple Dr, Vidalia, GA 30474 Phone: 912-537-0616 Fax: 912-537-0617 | |
Meadows Medical Group Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 621 E 1st St Ste B, Vidalia, GA 30474 Phone: 912-535-5120 | |
Optim Primary Care-vidalia Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1811 Edwina Drive, Vidalia, GA 30474 Phone: 912-537-9779 Fax: 912-537-2124 | |
Wiggins Family Practice Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 Arlington Dr, Vidalia, GA 30474 Phone: 912-537-2530 Fax: 912-537-2540 | |
Vidalia Neurology Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1707 Meadows Lane, Suite A, Vidalia, GA 30474 Phone: 912-537-9779 | |
Williams Rural Surgical & Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1604 Meadows Ln, Vidalia, GA 30474 Phone: 912-245-4179 Fax: 912-403-3346 |