Caryn J Masterman-smith, DO | |
125 Church St, Vidalia, GA 30474-4770 | |
(912) 538-8484 | |
(912) 538-8665 |
Full Name | Caryn J Masterman-smith |
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Gender | Female |
Speciality | Pediatrics |
Location | 125 Church St, Vidalia, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598767857 | NPI | - | NPPES |
880935875A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | OS8651 (Florida) | Secondary |
208000000X | Pediatrics | 63712 (Georgia) | Primary |
Entity Name | Meadows Multispecialty Associates Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952990533 PECOS PAC ID: 6002223484 Enrollment ID: O20210407000556 |
Mailing Address | Practice Location Address |
---|---|
Caryn J Masterman-smith, DO Po Box 407, Vidalia, GA 30475-0407 Ph: (912) 537-4986 | Caryn J Masterman-smith, DO 125 Church St, Vidalia, GA 30474-4770 Ph: (912) 538-8484 |
Dr. Erin Breeann Lindholm, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 125 Church St, Vidalia, GA 30474 Phone: 912-538-8484 Fax: 912-538-8665 | |
Etta Wilcia Boss Cole, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 414 Lugenia Blvd, Vidalia, GA 30474 Phone: 912-537-9355 Fax: 912-537-7038 | |
Lauren Courtney Miller, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 125 Church St, Vidalia, GA 30474 Phone: 912-538-8484 Fax: 912-538-8665 | |
Dr. Katrina Mcclane Leshanski, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 125 Church St, Vidalia, GA 30474 Phone: 912-538-8484 Fax: 912-538-8665 | |
Timothy Caron Horton, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1702 Meadows Ln Ste A, Vidalia, GA 30474 Phone: 912-538-8484 Fax: 912-538-8665 | |
Callie Wilkes, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 303 Harris Industrial Blvd Ste 3, Vidalia, GA 30474 Phone: 912-537-9355 |