| Dr James R Kisselburg, M,D | |
|
1900 Tebeau Street, Waycross, GA 31501 | |
| (912) 338-6438 | |
| (912) 338-6439 |
| Full Name | Dr James R Kisselburg |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 16 Years |
| Location | 1900 Tebeau Street, Waycross, Georgia |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841434255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | 76594 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bleckley Memorial Hospital | Cochran, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southland Emergency Medical Services Consolidated, Llc | 4183871320 | 37 |
| Southland Optim Jenkins Emergency Medical Services, Llc | 9537461538 | 17 |
| Southland Cochran Emergency Medical Services Llc | 9638398027 | 14 |
| Entity Name | Hospital Authority Of Candler County |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588868947 PECOS PAC ID: 5294623948 Enrollment ID: O20040305000415 |
| Entity Name | Mayo Clinic Health System In Waycross, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154745982 PECOS PAC ID: 0042124919 Enrollment ID: O20040308000639 |
| Entity Name | Southland Emergency Medical Services Consolidated, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033464391 PECOS PAC ID: 4183871320 Enrollment ID: O20120823000503 |
| Entity Name | Burke County Hospital Authority |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053672527 PECOS PAC ID: 5193971422 Enrollment ID: O20130401000294 |
| Entity Name | Southland Cochran Emergency Medical Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205241395 PECOS PAC ID: 9638398027 Enrollment ID: O20140917001247 |
| Entity Name | Southland Bainbridge Hospitalist Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356735336 PECOS PAC ID: 7214248335 Enrollment ID: O20150616002069 |
| Entity Name | Southland Consolidated Emergency Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174917124 PECOS PAC ID: 2860792066 Enrollment ID: O20151119001289 |
| Entity Name | Southland Optim Jenkins Emergency Medical Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265826242 PECOS PAC ID: 9537461538 Enrollment ID: O20160107002680 |
| Entity Name | Southland Dodge Emergency Medical Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851958607 PECOS PAC ID: 8224360805 Enrollment ID: O20191031001338 |
| Entity Name | Southland Burke Emergency Medical Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235885815 PECOS PAC ID: 9537547401 Enrollment ID: O20220606000360 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr James R Kisselburg, M,D 1900 Tebeau Street, Mayo Clinic Health System, Waycross, GA 31501 Ph: (912) 338-6438 | Dr James R Kisselburg, M,D 1900 Tebeau Street, Waycross, GA 31501 Ph: (912) 338-6438 |
Jules M Nehmetallah, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 410 Darling Ave, Waycross, GA 31501 Phone: 913-338-6438 | |
Roberto Jafet Lopez Vega, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 1900 Tebeau St, Waycross, GA 31501 Phone: 201-417-9656 |