| Roberto M Icarro, MD | |
| 
					1743 Watson Blvd, Suite B, Warner Robins, GA 31093-3633  | |
| (478) 328-2122 | |
| (478) 929-2242 | 
| Full Name | Roberto M Icarro | 
|---|---|
| Gender | Male | 
| Speciality | Internal Medicine | 
| Location | 1743 Watson Blvd, Warner Robins, Georgia | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1497703193 | NPI | - | NPPES | 
| 000944633C | Medicaid | GA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | 051049 (Georgia) | Primary | 
| 207RG0300X | Internal Medicine - Geriatric Medicine | 051049 (Georgia) | Secondary | 
| Entity Name | Central Georgia Heart Institue, Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1659313153 PECOS PAC ID: 7315902087 Enrollment ID: O20041122000706  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Roberto M Icarro, MD 1743 Watson Blvd, Suite B, Warner Robins, GA 31093-3633 Ph: (478) 328-2122  | Roberto M Icarro, MD 1743 Watson Blvd, Suite B, Warner Robins, GA 31093-3633 Ph: (478) 328-2122  | 
Dr. Richard Lyndon Smith Jr., M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 1260 Russell Pkwy, Warner Robins, GA 31088 Phone: 478-929-4100 Fax: 478-329-8814  | |
Preethi Mereddy, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1719 Russell Pkwy Ste 700, Warner Robins, GA 31088 Phone: 478-328-7674 Fax: 478-328-1393  | |
Bilal Rauf Khan, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1654 Watson Blvd, Warner Robins, GA 31093 Phone: 478-225-9882 Fax: 478-293-1217  | |
Navin Taneja, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 130 Hospital Dr, Warner Robins, GA 31088 Phone: 478-225-9983 Fax: 478-225-9981  | |
Dr. Gary Myrthil, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 107 Osigian Blvd Ste 100, Warner Robins, GA 31088 Phone: 478-953-2212 Fax: 478-953-2228  | |
Dr. John C Sams, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1719 Russell Pkwy Ste 700, Warner Robins, GA 31088 Phone: 478-328-7674  | |
Dr. Daniel Oliver Fussell, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1201 Briarcliff Rd., Warner Robins, GA 31088 Phone: 478-922-6413  |