| Mr Gordon Brent Waters, MD | |
|
120 E Carter Ave, Blackshear, GA 31516-1561 | |
| (912) 449-4426 | |
| (912) 449-1059 |
| Full Name | Mr Gordon Brent Waters |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 25 Years |
| Location | 120 E 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 |
|---|---|---|---|
| 1730109414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 052849 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Amedisys Home Health | Waycross, GA | Home health agency |
| Ware Visiting Nurses Service, Inc | Waycross, GA | Home health agency |
| Hospice Satilla Of Mem Hosp | Waycross, GA | Hospice |
| Mayo Clinic Health System In Waycross | Waycross, GA | Hospital |
| Wayne Memorial Hospital | Jesup, GA | Hospital |
| Bacon County Hospital | Alma, GA | Hospital |
| Harborview Satilla | Waycross, GA | Nursing home |
| Baptist Village, Inc. | Waycross, GA | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Camden Healthcare Associates Inc | 8123013455 | 9 |
| Entity Name | Camden Healthcare Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710927405 PECOS PAC ID: 8123013455 Enrollment ID: O20040416000920 |
| 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 | Hospital Physician Services - Southeast Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760410385 PECOS PAC ID: 5597774554 Enrollment ID: O20060419000545 |
| 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 Gordon Brent Waters, MD 120 E Carter Ave, Blackshear, GA 31516-1561 Ph: (912) 449-4426 | Mr Gordon Brent 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. Donald B. Waters, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 120 E Carter Ave, Blackshear, GA 31516 Phone: 912-449-4426 Fax: 912-449-1517 |