| David Allen Peterson, MD | |
|
801 W Gordon St, Thomaston, GA 30286-3426 | |
| (706) 647-8111 | |
| (706) 647-4389 |
| Full Name | David Allen Peterson |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 52 Years |
| Location | 801 W Gordon St, Thomaston, Georgia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699768382 | NPI | - | NPPES |
| 708309 | Other | BLUE CROSS BLUE SHIELD | |
| P00160614 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 022458 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Upson Regional Medical Center | Thomaston, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Guardian Medical Services Llc | 8325347735 | 24 |
| Entity Name | Sweet Dreams Nurse Anesthesia, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649463365 PECOS PAC ID: 5294823266 Enrollment ID: O20071109000111 |
| Entity Name | Synergy Anesthesiology Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003040502 PECOS PAC ID: 4385781954 Enrollment ID: O20091030000317 |
| Entity Name | Nmda Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306123336 PECOS PAC ID: 7113193541 Enrollment ID: O20120105000663 |
| Entity Name | Guardian Medical Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255786521 PECOS PAC ID: 8325347735 Enrollment ID: O20160505001064 |
| Mailing Address | Practice Location Address |
|---|---|
| David Allen Peterson, MD Po Box 589, Thomaston, GA 30286-0008 Ph: (706) 647-8111 | David Allen Peterson, MD 801 W Gordon St, Thomaston, GA 30286-3426 Ph: (706) 647-8111 |
Mary Street Logan, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 801 W Gordon St, Thomaston, GA 30286 Phone: 706-647-8111 Fax: 706-647-4389 |