| Mr Donald B Waters, MD | |
|
120 E Carter Ave, Blackshear, GA 31516-1561 | |
| (912) 449-4426 | |
| (912) 449-1517 |
| Full Name | Mr Donald B Waters |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 120 E Carter Ave, Blackshear, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972535615 | NPI | - | NPPES |
| 00071904A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 13804 (Georgia) | Primary |
| Entity Name | Mayo Clinic Health System In Waycross, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154745982 PECOS PAC ID: 0042124919 Enrollment ID: O20040308000639 |
| 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 | Privia Medical Group Of Georgia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013313857 PECOS PAC ID: 4284951542 Enrollment ID: O20150325000983 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Donald B Waters, MD 120 E Carter Ave, Blackshear, GA 31516-1561 Ph: (912) 449-4426 | Mr Donald B Waters, MD 120 E Carter Ave, Blackshear, GA 31516-1561 Ph: (912) 449-4426 |
Mr. Thomas W Davis, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 147 Longleaf Dr, Blackshear, GA 31516 Phone: 912-449-6243 | |
Ms. Susan Brickle, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 120 E Carter Ave, Blackshear, GA 31516 Phone: 912-449-4426 Fax: 912-449-1059 | |
Jeffrey P. Davenport, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 120 Carter Ave, Blackshear Family Practice, Blackshear, GA 31516 Phone: 912-449-4426 | |
Mr. Gordon Brent Waters, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 120 E Carter Ave, Blackshear, GA 31516 Phone: 912-449-4426 Fax: 912-449-1059 |