| Dr Bradley Dwayne Hare, MD | |
|
80 Interstate South Dr Ste B, Jasper, GA 30143 | |
| (706) 253-2430 | |
| Not Available |
| Full Name | Dr Bradley Dwayne Hare |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 21 Years |
| Location | 80 Interstate South Dr Ste B, Jasper, 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 |
|---|---|---|---|
| 1013154632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 072683 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Piedmont Mountainside Hospital Inc | Jasper, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Piedmont Specialty Hospital Billing Llc | 4183986490 | 202 |
| Piedmont Providers Llc | 9830082825 | 425 |
| Entity Name | Piedmont Providers Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548273592 PECOS PAC ID: 9830082825 Enrollment ID: O20040204000321 |
| Entity Name | Healogics Specialty Physicians Of Georgia, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265843536 PECOS PAC ID: 7214154392 Enrollment ID: O20140813001916 |
| Entity Name | Piedmont Specialty Hospital Billing Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699290510 PECOS PAC ID: 4183986490 Enrollment ID: O20180327001180 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Bradley Dwayne Hare, MD 2727 Paces Ferry Rd Se Ste 1-1100, Atlanta, GA 30339-6151 Ph: (706) 253-2430 | Dr Bradley Dwayne Hare, MD 80 Interstate South Dr Ste B, Jasper, GA 30143 Ph: (706) 253-2430 |
Michael Turner Rumble, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 80 Interstate South Dr, Suite B, Jasper, GA 30143 Phone: 678-454-3306 Fax: 678-454-3311 | |
George W Glazebrook, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 80 Interstate South Dr, Ste B, Jasper, GA 30143 Phone: 706-692-9081 Fax: 706-692-0155 | |
Rosa L Langella, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 80 Interstate South Dr, Ste B, Jasper, GA 30143 Phone: 706-692-9081 Fax: 706-692-0155 | |
Roy Chu, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 80 Interstate South Dr, Ste B, Jasper, GA 30143 Phone: 706-692-9081 Fax: 706-692-0155 | |
Carliss Christopher Graham, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 80 Interstate South Dr, Suite B, Jasper, GA 30143 Phone: 678-454-3306 Fax: 706-253-2431 |