| Dr Samrajya Lk Gogineni, MD | |
| 1390 Us Highway 19 S, Leesburg, GA 31763-4831 | |
| (229) 312-7490 | |
| (229) 312-7495 | 
| Full Name | Dr Samrajya Lk Gogineni | 
|---|---|
| Gender | Female | 
| Speciality | Internal Medicine | 
| Location | 1390 Us Highway 19 S, Leesburg, Georgia | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1306932983 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | 025160 (Georgia) | Primary | 
| Entity Name | Phoebe Physician Group Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1487899464 PECOS PAC ID: 8426112350 Enrollment ID: O20090121000583 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Samrajya Lk Gogineni, MD Po Box 84009, Columbus, GA 31908-4009 Ph: (229) 312-5800 | Dr Samrajya Lk Gogineni, MD 1390 Us Highway 19 S, Leesburg, GA 31763-4831 Ph: (229) 312-7490 | 
| Nicole Tahira Perrotte, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 235 Walnut Street, Leesburg, GA 31763 Phone: 229-759-6508 Fax: 229-759-9950 | |
| James Hotz, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 235 Walnut Ave S, Leesburg, GA 31763 Phone: 229-759-6508 Fax: 229-759-9950 | |
| Deirdre Mae Clairewen Lawson, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 235 Walnut Street, Leesburg, GA 31763 Phone: 229-759-6508 Fax: 229-759-9950 | |
| John Edward Vance, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 235 Walnut Ave S, Leesburg, GA 31763 Phone: 229-759-6508 |