| William D Jordan Jr, MD | |
|
1120 15th St, Augusta, GA 30912-1013 | |
| (706) 721-8623 | |
| Not Available |
| Full Name | William D Jordan Jr |
|---|---|
| Gender | Male |
| Speciality | Vascular Surgery |
| Experience | 37 Years |
| Location | 1120 15th St, Augusta, 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 |
|---|---|---|---|
| 1134159668 | NPI | - | NPPES |
| 000027366 | Medicaid | AL | |
| 770000637 | Other | AL | RAILROAD MEDICARE |
| E92967 | Other | AL | VIVA |
| 000027366 | Other | AL | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | 14678 (Alabama) | Secondary |
| 2086S0129X | Surgery - Vascular Surgery | 37578 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Au Medical Center | Augusta, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wellstar Medical Group Llc | 6709065402 | 2734 |
| Entity Name | The Emory Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396798229 PECOS PAC ID: 8820901408 Enrollment ID: O20031110000503 |
| Entity Name | Emory Medical Care Foundation Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063452381 PECOS PAC ID: 4981501814 Enrollment ID: O20031217000968 |
| Entity Name | Au Medical Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841230620 PECOS PAC ID: 9931013513 Enrollment ID: O20040107000188 |
| Entity Name | Wellstar Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
| Mailing Address | Practice Location Address |
|---|---|
| William D Jordan Jr, MD 1120 15th St # Or6000, Augusta, GA 30912-0004 Ph: (706) 721-3813 | William D Jordan Jr, MD 1120 15th St, Augusta, GA 30912-1013 Ph: (706) 721-8623 |
Dr. Erika Simmerman Mabes, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3052 Fax: 706-721-7501 | |
Dr. Elizabeth D Fox, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-8623 Fax: 706-721-1459 | |
Mary Kathryn Boggs, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3647 J Dewey Gray Cir Ste 200, Augusta, GA 30909 Phone: 706-504-9712 Fax: 706-504-9703 | |
Dr. James Raley, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-2503 Fax: 706-721-1047 | |
Dr. Kathryne Holmes, MD Surgery Medicare: Medicare Enrolled Practice Location: 1120 15th St Rm Bi4076, Augusta, GA 30912 Phone: 706-721-4651 | |
Mr. Keith F. O'malley, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3671 | |
Dr. Thuy-huong Thi Pham, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1120 15th St, Bl 4070, Augusta, GA 30912 Phone: 706-721-0000 Fax: 706-721-1047 |