| John T Madonna Jr, MD | |
|
333 W Carter Ave, Blackshear, GA 31516-1412 | |
| (912) 632-8961 | |
| (912) 632-5000 |
| Full Name | John T Madonna Jr |
|---|---|
| Gender | Male |
| Speciality | Cardiovascular Disease (cardiology) |
| Experience | 38 Years |
| Location | 333 W Carter Ave, Blackshear, 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 |
|---|---|---|---|
| 1912933870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RC0000X | Internal Medicine - Cardiovascular Disease | ME97383 (Florida) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 031981 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bacon County Hospital | Alma, GA | Hospital |
| Mayo Clinic Health System In Waycross | Waycross, GA | Hospital |
| Coffee Regional Medical Center, Inc | Douglas, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| South Georgia Physicians Group, Llc | 8224208251 | 8 |
| Entity Name | St Vincent's Ambulatory Care Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417987124 PECOS PAC ID: 2860411188 Enrollment ID: O20051129000302 |
| Entity Name | South Georgia Physicians Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336560952 PECOS PAC ID: 8224208251 Enrollment ID: O20110831000412 |
| Mailing Address | Practice Location Address |
|---|---|
| John T Madonna Jr, MD 1506 Alice St, Waycross, GA 31501-4531 Ph: (912) 285-9994 | John T Madonna Jr, MD 333 W Carter Ave, Blackshear, GA 31516-1412 Ph: (912) 632-8961 |
Dr. Dean Carl Broome, M.D, Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 115 Main St, Blackshear, GA 31516 Phone: 912-449-1477 Fax: 912-449-1479 |