| Dr Kentrez Gerrod Thompson, MD | |
| 485 Highway 29 N, Athens, GA 30601-5583 | |
| (706) 438-4080 | |
| Not Available | 
| Full Name | Dr Kentrez Gerrod Thompson | 
|---|---|
| Gender | Male | 
| Speciality | Family Medicine | 
| Location | 485 Highway 29 N, Athens, Georgia | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1770100398 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208600000X | Surgery | 84676 (South Carolina) | Secondary | 
| 207Q00000X | Family Medicine | 100753 (Georgia) | Primary | 
| Entity Name | Wellstreet Of Georgia Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1235411547 PECOS PAC ID: 7517126279 Enrollment ID: O20120315000603 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Kentrez Gerrod Thompson, MD 169 Ashley Avenue, Room 202 Main Hospital, Msc 333, Charleston, SC 29425 Ph: () - | Dr Kentrez Gerrod Thompson, MD 485 Highway 29 N, Athens, GA 30601-5583 Ph: (706) 438-4080 | 
| Dr. Ron Elliott, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 55 Carlton St, Athens, GA 30602 Phone: 706-542-8621 Fax: 706-583-0217 | |
| Dr. Garth Russo, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 55 Carlton St, Athens, GA 30602 Phone: 706-542-8621 Fax: 706-583-0217 | |
| Mr. Errol Duncan, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1061 Dowdy Rd, Suite 100, Athens, GA 30606 Phone: 706-621-7575 Fax: 706-621-7557 | |
| Samuel C Griffin, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 700 Sunset Dr, Suite 101, Athens, GA 30606 Phone: 706-548-6068 Fax: 706-354-1218 | |
| Ruth Adetoun Adene-peter, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 485 Highway 29 N, Athens, GA 30601 Phone: 706-438-4080 Fax: 706-438-4081 | |
| Jordan Phillips, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 700 Oglethorpe Ave Ste C7, Athens, GA 30606 Phone: 706-425-9445 | |
| Michael N Carter, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 892 Prince Ave, Athens, GA 30606 Phone: 706-227-2027 Fax: 706-227-2433 |