| Mark Thomas Brulte, MD | |
|
200 Doctors Dr, Suite 106, Douglas, GA 31533-2201 | |
| (912) 384-3338 | |
| (912) 389-0979 |
| Full Name | Mark Thomas Brulte |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 33 Years |
| Location | 200 Doctors Dr, Douglas, 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 |
|---|---|---|---|
| 1205931672 | NPI | - | NPPES |
| 0008734441F | Medicaid | GA | |
| GRP7301 | Other | GA | MEDICARE GROUP # |
| 000873441H | Medicaid | GA | |
| 478042 | Other | GA | WELLCARE-DOUGLAS |
| 543782 | Other | GA | WELLCARE-NICHOLLS |
| 000873441I | Medicaid | GA | |
| 00873441A | Medicaid | GA | |
| 541189 | Other | GA | WELLCARE-WILLACOOCHEE |
| 128214 | Other | GA | PEACHSTATE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 048490 (Georgia) | Secondary |
| 207R00000X | Internal Medicine | 048490 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Coffee Regional Medical Center, Inc | Douglas, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Coffee Regional Medical Center Inc | 4587656012 | 21 |
| Coffee Emergency Group Llc | 4880834050 | 9 |
| Entity Name | Tift Regional Health System, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790280857 PECOS PAC ID: 5193619971 Enrollment ID: O20040212000064 |
| Entity Name | Coffee Regional Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437120946 PECOS PAC ID: 4587656012 Enrollment ID: O20040402000287 |
| Entity Name | Nes Georgia Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144201559 PECOS PAC ID: 0345210001 Enrollment ID: O20040729000602 |
| Entity Name | Douglas Medical Specialist |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154475085 PECOS PAC ID: 6204868862 Enrollment ID: O20050902000434 |
| Entity Name | Ben Hill Emergency Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043328156 PECOS PAC ID: 3274530837 Enrollment ID: O20061025000232 |
| Entity Name | Coffee Emergency Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023353489 PECOS PAC ID: 4880834050 Enrollment ID: O20130711000400 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Thomas Brulte, MD 200 Doctors Dr, Suite 106, Douglas, GA 31533-2201 Ph: (912) 384-3338 | Mark Thomas Brulte, MD 200 Doctors Dr, Suite 106, Douglas, GA 31533-2201 Ph: (912) 384-3338 |
Dr. Akhil Baranwal, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1105 Lee Ave, Douglas, GA 31533 Phone: 912-393-5051 Fax: 954-301-6333 | |
Sudhakar Jonnalagadda, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 300 Shirley Ave, Douglas, GA 31533 Phone: 912-384-7275 Fax: 912-384-4343 | |
Mr. Dennis Conrad Harper, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1400 N. Peterson Avenue, Suite C, Douglas, GA 31533 Phone: 912-384-4000 Fax: 912-384-4085 | |
Dr. Willie W Bell, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1305 Ocilla Rd, Douglas, GA 31533 Phone: 912-384-0600 Fax: 912-384-0601 | |
Dr. John David Arnett, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 200 Doctors Dr, Suite 106, Douglas, GA 31533 Phone: 912-384-3338 | |
Dr. Joel W Ferree, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1305 Ocilla Rd, Douglas, GA 31533 Phone: 912-384-0600 Fax: 912-384-0601 | |
Dr. Glenn Hamilton Evans Sr., MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1305 Ocilla Rd, Douglas, GA 31533 Phone: 912-384-0600 Fax: 912-384-0601 |