| Dr Dan C Martin, MD | |
|
1008 Druid Park Ave Ste 101, Augusta, GA 30904-5848 | |
| (770) 962-3642 | |
| (770) 962-3643 |
| Full Name | Dr Dan C Martin |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology - Pain Medicine |
| Location | 1008 Druid Park Ave Ste 101, Augusta, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578595831 | NPI | - | NPPES |
| G24031 | Medicaid | SC | |
| 000288626E | Medicaid | GA | |
| 339275 | Other | GA | WELLCARE CMO |
| 050090631 | Other | GA | RRMEDICARE |
| 550789920 | Other | GA | TRICARE |
| 048398 | Other | GA | BCBS |
| 000288626F | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 024031 (Georgia) | Secondary |
| 207LP2900X | Anesthesiology - Pain Medicine | 024031 (Georgia) | Primary |
| Entity Name | Georgia Pain And Wellness Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356781181 PECOS PAC ID: 8527200864 Enrollment ID: O20130815000433 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Dan C Martin, MD 455 Philip Blvd Ste 140, Lawrenceville, GA 30046-8768 Ph: (770) 962-3642 | Dr Dan C Martin, MD 1008 Druid Park Ave Ste 101, Augusta, GA 30904-5848 Ph: (770) 962-3642 |
Rosa Maria Lopez Rincon, Anesthesiology Medicare: Medicare Enrolled Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-446-5836 | |
Yulia Kungurova, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1120 15th St # Bi-2183, Augusta, GA 30912 Phone: 706-721-0180 | |
Richard E. Lynch, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 804 Scott Nixon Memorial Dr, Attn: Provider Enrollment, Augusta, GA 30907 Phone: 800-394-4445 Fax: 706-955-0735 | |
Dr. Edward Kurt Leahy, Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1 Freedom Way, Augusta, GA 30904 Phone: 706-733-0188 | |
Dr. Marshall D. Bedder, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3813 | |
Dr. John William Whiteley, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3873 Fax: 706-721-7763 | |
Sami Mohammad Hafsa, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3871 |