| Stephen A Nickisch, MD | |
|
2060 Dan Proctor Dr, Suite 1200, Saint Marys, GA 31558-3894 | |
| (912) 540-6750 | |
| (912) 540-6773 |
| Full Name | Stephen A Nickisch |
|---|---|
| Gender | Male |
| Speciality | Obstetrics/gynecology |
| Experience | 35 Years |
| Location | 2060 Dan Proctor Dr, Saint Marys, 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 |
|---|---|---|---|
| 1578596615 | NPI | - | NPPES |
| 000099105 | Other | BCBS | |
| 0093279 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 10278 (Montana) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Obhg Georgia, P.c. | 9032383583 | 13 |
| Entity Name | Cooperative Healthcare Services, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417979402 PECOS PAC ID: 9830093640 Enrollment ID: O20031124000222 |
| Entity Name | Obhg Georgia, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750686838 PECOS PAC ID: 9032383583 Enrollment ID: O20111117000602 |
| Entity Name | Sgmc Physician Network Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417597170 PECOS PAC ID: 4082036843 Enrollment ID: O20201015000629 |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen A Nickisch, MD 2060 Dan Proctor Dr, Suite 1200, Saint Marys, GA 31558-3894 Ph: (912) 540-6750 | Stephen A Nickisch, MD 2060 Dan Proctor Dr, Suite 1200, Saint Marys, GA 31558-3894 Ph: (912) 540-6750 |
Livio Federico Pardi, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 203 Lakeshore Pt, Saint Marys, GA 31558 Phone: 912-576-6465 | |
Dr. Richard Lyle Brandon, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 202 Lakeshore Dr, Suite A, Saint Marys, GA 31558 Phone: 912-673-1771 Fax: 912-673-1811 | |
Shanna Michele Welgraven, DO Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 2060 Dan Proctor Dr Ste 1200, Saint Marys, GA 31558 Phone: 912-540-6750 Fax: 912-540-6773 | |
Michelle Yvonne Perry, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 2060 Dan Proctor Dr, Suite 1800, Saint Marys, GA 31558 Phone: 912-510-7376 Fax: 912-510-7377 | |
Dr. Roxanne R Mody, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 2060 Dan Proctor Dr Ste 1200, Saint Marys, GA 31558 Phone: 912-540-6750 |