| Edward John Fricker, MD | |
|
3207 Country Club Dr, Valdosta, GA 31605-1029 | |
| (229) 242-8480 | |
| (229) 247-7539 |
| Full Name | Edward John Fricker |
|---|---|
| Gender | Male |
| Speciality | Gastroenterology |
| Experience | 38 Years |
| Location | 3207 Country Club Dr, Valdosta, 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 |
|---|---|---|---|
| 1316933823 | NPI | - | NPPES |
| 00610915A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 038487 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Cook Medical Center A Campus Of Tift Reg Med Ctr | Adel, GA | Hospital |
| Tift Regional Medical Center | Tifton, GA | Hospital |
| South Georgia Medical Center | Valdosta, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southwell Ambulatory Inc | 9234566779 | 10 |
| Entity Name | Valdosta Medical Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538200035 PECOS PAC ID: 9234197286 Enrollment ID: O20041222000501 |
| Entity Name | Privia Medical Group Of Georgia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013313857 PECOS PAC ID: 4284951542 Enrollment ID: O20150325000983 |
| Entity Name | Southwell Ambulatory Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164069472 PECOS PAC ID: 9234566779 Enrollment ID: O20200224001260 |
| Mailing Address | Practice Location Address |
|---|---|
| Edward John Fricker, MD 3207 Country Club Dr, Valdosta, GA 31605-1029 Ph: (229) 242-8480 | Edward John Fricker, MD 3207 Country Club Dr, Valdosta, GA 31605-1029 Ph: (229) 242-8480 |
Dr. Asma Yasin, MBBS Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 2501 N Patterson St, Valdosta, GA 31602 Phone: 229-259-4178 | |
Dr. Nikolay Gogin, MD Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 2501 N Patterson St, Valdosta, GA 31602 Phone: 229-259-4131 | |
Dr. Felix G Valdez, MD Gastroenterology Medicare: May Accept Medicare Assignments Practice Location: 2501 N Patterson St, Valdosta, GA 31602 Phone: 229-259-4501 Fax: 229-259-4502 | |
Dr. Moriamo Adedoyin Fashugba, MD Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 2501 N Patterson St, Valdosta, GA 31602 Phone: 229-433-1000 | |
Zubair Akram, MD Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 2501 N Patterson St, Valdosta, GA 31602 Phone: 229-433-1000 | |
Dr. Gerald S Light, MD Gastroenterology Medicare: Medicare Enrolled Practice Location: 3564b Northcrossing Cir, Valdosta, GA 31602 Phone: 229-247-1414 Fax: 229-247-1978 | |
Dr. William C Tidmore Jr., M.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 2418 N Oak St, Valdosta, GA 31602 Phone: 229-219-0247 Fax: 229-219-0837 |