| Brett Wynn, MD | |
|
705 Dixie St, Carrollton, GA 30117-3818 | |
| (770) 836-9666 | |
| Not Available |
| Full Name | Brett Wynn |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine - Emergency Medical Services |
| Location | 705 Dixie St, Carrollton, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063478139 | NPI | - | NPPES |
| 918889310A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207PE0004X | Emergency Medicine - Emergency Medical Services | 057269 (Georgia) | Primary |
| 207P00000X | Emergency Medicine | 37295 (Kentucky) | Secondary |
| Entity Name | Georgia Em-i Medical Services Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285682583 PECOS PAC ID: 0446157218 Enrollment ID: O20031218000621 |
| Entity Name | Carrollton Emergency Physicians Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790724672 PECOS PAC ID: 7416860010 Enrollment ID: O20040122001028 |
| Entity Name | Independence Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164458832 PECOS PAC ID: 2264484971 Enrollment ID: O20050210000513 |
| Entity Name | Houston County Emergency Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013338193 PECOS PAC ID: 2264663756 Enrollment ID: O20140326001461 |
| Mailing Address | Practice Location Address |
|---|---|
| Brett Wynn, MD 157 Carson Pl, Carrollton, GA 30117-4647 Ph: () - | Brett Wynn, MD 705 Dixie St, Carrollton, GA 30117-3818 Ph: (770) 836-9666 |
Jesse Mitchell Jr., M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 705 Dixie St, Carrollton, GA 30117 Phone: 770-836-9666 | |
Nathan Hundley, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 705 Dixie St, Carrollton, GA 30117 Phone: 770-812-9597 | |
Michael Eckert, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 705 Dixie St, Tanner Health Systems, Emergency Dept, Carrollton, GA 30117 Phone: 770-836-9666 | |
Richard Whitaker, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 705 Dixie St, Carrollton, GA 30117 Phone: 770-836-9666 | |
Theodore Nicholson, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 705 Dixie St, Carrollton, GA 30117 Phone: 770-836-9666 | |
Timothy Paul, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 705 Dixie St, Carrollton, GA 30117 Phone: 770-836-9666 |