| Dr Jack R Eades, MD | |
|
6501 Peake Rd Ste 1000, Macon, GA 31210-8052 | |
| (478) 607-2514 | |
| (478) 607-2513 |
| Full Name | Dr Jack R Eades |
|---|---|
| Gender | Male |
| Speciality | Allergy & Immunology |
| Location | 6501 Peake Rd Ste 1000, Macon, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992890727 | NPI | - | NPPES |
| 00751264D | Medicaid | GA | |
| 00751264F | Medicaid | GA | |
| G43360 | Medicaid | SC | |
| 00751264E | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207K00000X | Allergy & Immunology | 20053 (South Carolina) | Secondary |
| 207K00000X | Allergy & Immunology | 043360 (Georgia) | Primary |
| Entity Name | Southcoast Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467451922 PECOS PAC ID: 9032013271 Enrollment ID: O20040109000192 |
| Entity Name | Wellstar Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
| Entity Name | Langford Allergy Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215351291 PECOS PAC ID: 6103057054 Enrollment ID: O20140318002105 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jack R Eades, MD 6501 Peake Rd Ste 1000, Macon, GA 31210-8052 Ph: (478) 607-2514 | Dr Jack R Eades, MD 6501 Peake Rd Ste 1000, Macon, GA 31210-8052 Ph: (478) 607-2514 |
Dr. Rahul Kumar Vangala, M.D. Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 3964 Elnora Dr, Macon, GA 31210 Phone: 478-477-1777 Fax: 478-477-1779 | |
Dr. David T Plaxico, M.D Allergy & Immunology Medicare: Medicare Enrolled Practice Location: 2076 Ingleside Ave, Macon, GA 31204 Phone: 478-743-9376 Fax: 478-743-4670 | |
Mrs. Kayla Sue Whitley, DNP, APRN, FNP-C Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 2076 Ingleside Ave, Macon, GA 31204 Phone: 478-254-8305 |