| Dr Willis E Moody Iii, MD | |
|
191 Deep South Farm Rd, Blairsville, GA 30512-2220 | |
| (706) 781-6950 | |
| Not Available |
| Full Name | Dr Willis E Moody Iii |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 36 Years |
| Location | 191 Deep South Farm Rd, Blairsville, 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 |
|---|---|---|---|
| 1497736664 | NPI | - | NPPES |
| 000570534D | Other | GA | MEDICAID |
| 839014891 | Medicaid | GA | |
| 1487774261 | Other | GA | GROUP NPI |
| 386024 | Other | GA | WELLCARE |
| 20-5788381 | Other | GA | TAX ID |
| GRP8005 | Other | GA | GROUP IDENTIFIER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 058708 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Union General Hospital | Blairsville, GA | Hospital |
| Northside Hospital | Atlanta, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Union General Affiliated Services, Llc | 4688927106 | 21 |
| Entity Name | Georgia Mountain Surgical Associates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487774261 PECOS PAC ID: 9638274640 Enrollment ID: O20070420000031 |
| Entity Name | Union General Affiliated Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902305063 PECOS PAC ID: 4688927106 Enrollment ID: O20181031001616 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Willis E Moody Iii, MD 35 Hospital Rd, Blairsville, GA 30512-3139 Ph: (706) 745-2111 | Dr Willis E Moody Iii, MD 191 Deep South Farm Rd, Blairsville, GA 30512-2220 Ph: (706) 781-6950 |
Dr. William Henry Frazier, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 123 Weaver Road, Suite B, Blairsville, GA 30512 Phone: 706-439-6486 Fax: 706-745-7271 | |
Clifford T Thompson, MD Surgery Medicare: Medicare Enrolled Practice Location: 191 Deep South Farm Rd, Blairsville, GA 30512 Phone: 706-781-6950 | |
Jonathan A Bloch, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 191 Deep South Farm Rd, Blairsville, GA 30512 Phone: 706-781-6950 |