| Joshua P Dietzer, MD | |
|
3131 S Main St, Emergency Department, Moultrie, GA 31768-6925 | |
| (850) 391-1752 | |
| (850) 273-6357 |
| Full Name | Joshua P Dietzer |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 16 Years |
| Location | 3131 S Main St, Moultrie, 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 |
|---|---|---|---|
| 1306080759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 66479 (Georgia) | Primary |
| 207P00000X | Emergency Medicine | ME107771 (Florida) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Piedmont Columbus Regional Midtown | Columbus, GA | Hospital |
| Bayfront Health Seven Rivers | Crystal river, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Emergency Group Of Columbus Llc | 2668735515 | 41 |
| Southland Hospitalist At Weems Pl | 2860667508 | 7 |
| Paragon Emergency Services Llc | 8628153087 | 326 |
| Southland Ems At Weems Pl | 8820263171 | 4 |
| Entity Name | Colquitt Regional Emergency Physicians, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902211642 PECOS PAC ID: 6901026509 Enrollment ID: O20141002001293 |
| Entity Name | Emergency Group Of Columbus Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316458227 PECOS PAC ID: 2668735515 Enrollment ID: O20180406001191 |
| Entity Name | Heritage Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003321969 PECOS PAC ID: 6305100850 Enrollment ID: O20180509000280 |
| Mailing Address | Practice Location Address |
|---|---|
| Joshua P Dietzer, MD 6300 90th Ave N, Pinellas Park, FL 33782-4709 Ph: (850) 391-1752 | Joshua P Dietzer, MD 3131 S Main St, Emergency Department, Moultrie, GA 31768-6925 Ph: (850) 391-1752 |
Dr. Robert L Sasine, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 3131 S Main St, Moultrie, GA 31768 Phone: 229-985-3420 | |
Dr. Michael A Thayer, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 3131 S Main St, Moultrie, GA 31768 Phone: 229-985-3420 |