| Dr Tyler J Provost, DO | |
|
2508 University Dr, Thomson, GA 30824-0040 | |
| (706) 595-1090 | |
| (706) 595-6010 |
| Full Name | Dr Tyler J Provost |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 10 Years |
| Location | 2508 University Dr, Thomson, Georgia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588186191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 89610 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| University Mcduffie County Regional Medical Center | Thomson, GA | Hospital |
| University Hospital | Augusta, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Neighborhood Improvement Project, Inc | 7315851078 | 57 |
| Entity Name | Neighborhood Improvement Project, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700900867 PECOS PAC ID: 7315851078 Enrollment ID: O20031117000665 |
| Entity Name | Family Care Group Of Thomson Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669660783 PECOS PAC ID: 9133153273 Enrollment ID: O20050919000990 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tyler J Provost, DO 2508 University Dr, Thomson, GA 30824-0040 Ph: (706) 595-1090 | Dr Tyler J Provost, DO 2508 University Dr, Thomson, GA 30824-0040 Ph: (706) 595-1090 |
Dr. Susan H Land, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 505 Mount Pleasant Rd, Thomson, GA 30824 Phone: 706-595-1461 Fax: 706-597-9824 | |
Ms. Kelli M Carter, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1113 Washington Rd, Thomson, GA 30824 Phone: 706-595-7825 Fax: 706-595-1235 | |
Roger F. Nelson, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 315 Fluker St, Thomson, GA 30824 Phone: 706-595-1090 Fax: 706-595-6010 | |
Dr. Amy Leurinda, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1043 Washington Rd, Thomson, GA 30824 Phone: 706-595-1461 Fax: 706-597-9824 | |
Dr. Holly Barmore Mahoney, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 505 Mount Pleasant Rd, Thomson, GA 30824 Phone: 706-595-1461 | |
Dr. Daryl Carson Wiley, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 315 Fluker St, Thomson, GA 30824 Phone: 706-595-1090 Fax: 706-595-6010 |