| Aiden Brummett, PA-C | |
|
300 East Hospital Road, Fort Gordon, GA 30905-5650 | |
| (706) 787-1745 | |
| (706) 787-1745 |
| Full Name | Aiden Brummett |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 300 East Hospital Road, Fort Gordon, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588376842 | NPI | - | NPPES |
| 16134964 | Other | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 5255 (South Carolina) | Primary |
| 363A00000X | Physician Assistant | 12210 (Georgia) | Secondary |
| Entity Name | Psychiatric Professionals of Georgia, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396277968 PECOS PAC ID: 2567731482 Enrollment ID: O20170710001727 |
| Entity Name | Christopher Dennis MD PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588090229 PECOS PAC ID: 7416254990 Enrollment ID: O20190327002643 |
| Mailing Address | Practice Location Address |
|---|---|
| Aiden Brummett, PA-C 300 East Hospital Road, Fort Gordon, GA 30905-5650 Ph: Not Available | Aiden Brummett, PA-C 300 East Hospital Road, Fort Gordon, GA 30905-5650 Ph: (706) 787-1745 |
Mr. Gordon Andrew Marshall, PHYSICIAN ASSISTANT Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 300 West Hospital Road, Eisenhower Army Medical Center Attn Credentials, Fort Gordon, GA 30905 Phone: 706-787-2720 Fax: 706-787-8176 |
Mr. Nathan David Tavolieri, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 300 W Hospital Rd, Building 329, Fort Gordon, GA 30905 Phone: 706-787-3805 |
Nelson A Liuzzo, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 300 W Hospital Rd, Fort Gordon, GA 30905 Phone: 706-787-5811 |
Mrs. Sunny Maria Holden, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 300 E Hospital Road, Building T-300, Eisenhower Army Med Center Orthopedic Surgery Dept, Fort Gordon, GA 30905 Phone: 706-787-6157 Fax: 706-787-2901 |
Ms. Maria Teresa Richard, PAC Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 300 W Hospital Rd, Fort Gordon, GA 30905 Phone: 706-727-2720 Fax: 706-787-8176 |
Deidres Higgins, P.A. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 300 W Hospital Rd, Ddeamc, Fort Gordon, GA 30905 Phone: 706-787-6845 |
Mr. Rodney Micah Faught Ii, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 300 W Hospital Rd, Fort Gordon, GA 30905 Phone: 706-787-5811 |