| Michael Wren Gorum, MD | |
|
1538 13th. Ave., Suite B300, Columbus, GA 31901-3700 | |
| (706) 321-9300 | |
| (706) 321-9384 |
| Full Name | Michael Wren Gorum |
|---|---|
| Gender | Male |
| Speciality | Neurological Surgery |
| Location | 1538 13th. Ave., Columbus, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174685101 | NPI | - | NPPES |
| 000766004B | Medicaid | GA | |
| 367345 | Other | GA | BCBS PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207T00000X | Neurological Surgery | 44471 (Georgia) | Primary |
| Entity Name | Southeast Brain & Spine Surgery Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023175999 PECOS PAC ID: 3870563604 Enrollment ID: O20051024001149 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Wren Gorum, MD 1538 13th Ave, Ste B300, Columbus, GA 31901-2563 Ph: (706) 321-9300 | Michael Wren Gorum, MD 1538 13th. Ave., Suite B300, Columbus, GA 31901-3700 Ph: (706) 321-9300 |
Marc S Goldman, M.D. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1538 13th. Ave, Suite B300, Columbus, GA 31901 Phone: 706-321-9300 Fax: 706-321-9384 | |
Mrs. Levie Gracelyn Jones, NP Neurological Surgery Medicare: Medicare Enrolled Practice Location: 710 Center St, Columbus, GA 31901 Phone: 706-649-6600 |