| Jeffrey G Proctor, MD | |
|
970 Joe Frank Harris Pkwy Se, Suite 260, Cartersville, GA 30120-2159 | |
| (770) 607-1893 | |
| (770) 607-2930 |
| Full Name | Jeffrey G Proctor |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 39 Years |
| Location | 970 Joe Frank Harris Pkwy Se, Cartersville, 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 |
|---|---|---|---|
| 1902900459 | NPI | - | NPPES |
| 000770888A | Medicaid | GA | |
| 340016381 | Other | GA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 043267 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Cartersville Medical Center | Cartersville, GA | Hospital |
| Northside Hospital | Atlanta, GA | Hospital |
| Northside Hospital Cherokee | Canton, GA | Hospital |
| Wellstar Kennestone Hospital | Marietta, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Georgia Urology, Pa | 8921094376 | 88 |
| Urological Professional Services, Llc | 9638391717 | 62 |
| Entity Name | Georgia Urology, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245250646 PECOS PAC ID: 8921094376 Enrollment ID: O20040422000123 |
| Entity Name | Urological Professional Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033521810 PECOS PAC ID: 9638391717 Enrollment ID: O20141104002579 |
| Entity Name | Georgia Urology Piedmont Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376163451 PECOS PAC ID: 2860822145 Enrollment ID: O20200429001254 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey G Proctor, MD 1930 Brannan Rd, Mcdonough, GA 30253-4310 Ph: (678) 284-4040 | Jeffrey G Proctor, MD 970 Joe Frank Harris Pkwy Se, Suite 260, Cartersville, GA 30120-2159 Ph: (770) 607-1893 |
Anuj Sunil Desai, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 970 Joe Frank Harris Pkwy Se Ste 260, Cartersville, GA 30120 Phone: 770-607-1893 | |
James Durward Black Jr., MD Urology Medicare: Accepting Medicare Assignments Practice Location: 300 Courtyard Dr., Suite B, Cartersville, GA 30120 Phone: 770-386-1076 Fax: 770-606-0452 |