| Philip T Slack, MD | |
|
1315 Jesse Jewell Pkwy Ne Ste 300, Gainesville, GA 30501-3822 | |
| (770) 219-6520 | |
| (770) 219-1016 |
| Full Name | Philip T Slack |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 36 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 |
|---|---|---|---|
| 1639113095 | NPI | - | NPPES |
| 000552824C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 035523 (Georgia) | Secondary |
| 207LP2900X | Anesthesiology - Pain Medicine | 035523 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Northeast Georgia Medical Center, Inc | Gainesville, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Northeast Georgia Physicians Group Inc | 6901898386 | 706 |
| 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 |
|---|---|
| Philip T Slack, MD Po Box 742616, Atlanta, GA 30374-2616 Ph: (770) 219-8420 | Philip T Slack, MD 1315 Jesse Jewell Pkwy Ne Ste 300, Gainesville, GA 30501-3822 Ph: (770) 219-6520 |
Christine D Lallos, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 743 Spring St Ne, Gainesville, GA 30501 Phone: 770-219-9000 Fax: 770-219-6021 | |
Dr. Britton David Knowles, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 743 Spring St Ne, Gainesville, GA 30501 Phone: 770-532-7179 Fax: 770-534-1312 | |
Eric D Shapiro, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 743 Spring St Ne, Gainesville, GA 30501 Phone: 770-532-7179 Fax: 770-534-1312 | |
John Mark Zimmerman, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 743 Spring St Ne, Gainesville, GA 30501 Phone: 770-532-7179 Fax: 770-534-1312 | |
Allison B Johnson, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 743 Spring St Ne, Gainesville, GA 30501 Phone: 770-532-7179 | |
Dr. Martin L. Bremer, D.O. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1296 Sims Street, Suite B, Gainesville, GA 30501 Phone: 770-534-1856 | |
Robert J Winham, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 743 Spring St Ne, Gainesville, GA 30501 Phone: 770-532-7179 Fax: 770-534-1312 |