| Pavan Tummala, MD | |
|
1315 Jesse Jewell Pkwy Ne Ste 300, Gainesville, GA 30501-3875 | |
| (770) 219-6520 | |
| Not Available |
| Full Name | Pavan Tummala |
|---|---|
| Gender | Male |
| Speciality | Neurology |
| Experience | 22 Years |
| Location | 1315 Jesse Jewell Pkwy Ne Ste 300, Gainesville, 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 |
|---|---|---|---|
| 1407111313 | NPI | - | NPPES |
| 200028679 | Medicaid | MO | |
| 1407111313 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 2016026000 (Missouri) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | 96271 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Georgia Home Health | Atlanta, GA | Home health agency |
| Northeast Georgia Medical Center, Inc | Gainesville, GA | Hospital |
| St James Healthcare | Butte, MT | Hospital |
| St Vincent Healthcare | Billings, MT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Northeast Georgia Physicians Group Inc | 6901898386 | 706 |
| Scl Health Montana | 3476457714 | 39 |
| Entity Name | Northeast Georgia Physicians Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891745212 PECOS PAC ID: 6901898386 Enrollment ID: O20040402001277 |
| Mailing Address | Practice Location Address |
|---|---|
| Pavan Tummala, MD Po Box 742616, Atlanta, GA 30374-2616 Ph: (770) 219-8420 | Pavan Tummala, MD 1315 Jesse Jewell Pkwy Ne Ste 300, Gainesville, GA 30501-3875 Ph: (770) 219-6520 |
Dr. Polina P Shvarts, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 500 Jesse Jewell Pkwy Se, Ste 207, Gainesville, GA 30501 Phone: 770-718-9790 Fax: 888-504-7955 | |
Pamela Ann Pacquiao, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 743 Spring St Ne, Gainesville, GA 30501 Phone: 770-219-6000 | |
Mahitha Kolli, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 200 Wisteria Dr, Gainesville, GA 30501 Phone: 770-219-5407 | |
Michael Dehong Liu, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 743 Spring St Ne, Gainesville, GA 30501 Phone: 770-219-9000 | |
Deepti C Challagolla, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 200 Wisteria Dr, Gainesville, GA 30501 Phone: 770-219-5407 | |
Dr. Jackson Campbell Hortenstine, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1075 Jesse Jewell Pkwy Ne Ste B, Gainesville, GA 30501 Phone: 770-219-5407 | |
Dr. Clinton Emmitt Branch Jr., M.D., F.A.A.N. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1240 Jesse Jewell Pkwy Se, Suite 400, Gainesville, GA 30501 Phone: 770-534-1117 Fax: 770-503-7285 |