| Dr Ellen Eanes Courson, MD | |
|
604 E Park Ave, Valdosta, GA 31602-3060 | |
| (229) 333-0277 | |
| (229) 241-1608 |
| Full Name | Dr Ellen Eanes Courson |
|---|---|
| Gender | Female |
| Speciality | Obstetrics & Gynecology |
| Location | 604 E Park Ave, Valdosta, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528080496 | NPI | - | NPPES |
| 355750 | Other | GA | WELLCARE |
| 000470533A | Medicaid | GA | |
| 062093 | Other | GA | BLUECROSSBLUESHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 0343089 (Georgia) | Primary |
| Entity Name | Sgmc Physician Network Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417597170 PECOS PAC ID: 4082036843 Enrollment ID: O20201015000629 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ellen Eanes Courson, MD Po Box 2130, Valdosta, GA 31604-2130 Ph: (229) 333-0277 | Dr Ellen Eanes Courson, MD 604 E Park Ave, Valdosta, GA 31602-3060 Ph: (229) 333-0277 |
Joe C Clifton, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 220 Northside Drive, Valdosta, GA 31602 Phone: 229-241-2800 Fax: 229-241-0454 | |
Roy E Swindle Jr., MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 220 Northside Drive, Valdosta, GA 31602 Phone: 229-241-2800 Fax: 229-241-0454 | |
Sara N Yarbrough, DO Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 220 Northside Drive, Valdosta, GA 31602 Phone: 229-241-2800 Fax: 229-241-0454 | |
Alexander M Culbreth Iii, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 220 Northside Drive, Valdosta, GA 31602 Phone: 229-241-2800 Fax: 229-241-0454 | |
Jerthitia S Taylor, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 2601 Bemiss Rd, Suite A, Valdosta, GA 31602 Phone: 229-242-6677 Fax: 229-242-1870 | |
Bolan P Woodward, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 220 Northside Drive, Valdosta, GA 31602 Phone: 229-241-2800 Fax: 229-241-0454 |