| Nicole Tahira Perrotte, MD | |
|
235 Walnut Street, Leesburg, GA 31763 | |
| (229) 759-6508 | |
| (229) 759-9950 |
| Full Name | Nicole Tahira Perrotte |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Location | 235 Walnut Street, Leesburg, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134371446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 061636 (Georgia) | Primary |
| Entity Name | Cogent Healthcare Of Georgia Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609827823 PECOS PAC ID: 2961483607 Enrollment ID: O20040527000856 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Tahira Perrotte, MD 204 N Westover Blvd, Albany, GA 31707-2983 Ph: (229) 888-6559 | Nicole Tahira Perrotte, MD 235 Walnut Street, Leesburg, GA 31763 Ph: (229) 759-6508 |
James Hotz, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 235 Walnut Ave S, Leesburg, GA 31763 Phone: 229-759-6508 Fax: 229-759-9950 | |
Deirdre Mae Clairewen Lawson, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 235 Walnut Street, Leesburg, GA 31763 Phone: 229-759-6508 Fax: 229-759-9950 | |
Dr. Samrajya L.k. Gogineni, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 1390 Us Highway 19 S, Leesburg, GA 31763 Phone: 229-312-7490 Fax: 229-312-7495 | |
John Edward Vance, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 235 Walnut Ave S, Leesburg, GA 31763 Phone: 229-759-6508 |