| Jerry Dewayne Wilson, PA-C | |
|
4500 Hugh Howell Rd, Suite, Tucker, GA 30084-4723 | |
| (678) 632-4003 | |
| (678) 681-1305 |
| Full Name | Jerry Dewayne Wilson |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 29 Years |
| Location | 4500 Hugh Howell Rd, Tucker, 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 |
|---|---|---|---|
| 1619153210 | NPI | - | NPPES |
| 308036587A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 003052 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Emory Hillandale Hospital | Lithonia, GA | Hospital |
| Emory Decatur Hospital | Decatur, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Emory Specialty Associates, Llc | 3476559782 | 706 |
| Entity Name | Emory Specialty Associates, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407864168 PECOS PAC ID: 3476559782 Enrollment ID: O20061010000447 |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry Dewayne Wilson, PA-C Po Box 360550, Decatur, GA 30036-0550 Ph: (678) 632-4003 | Jerry Dewayne Wilson, PA-C 4500 Hugh Howell Rd, Suite, Tucker, GA 30084-4723 Ph: (678) 632-4003 |
Betsnat Mengesha, Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 4292 Chamblee Tucker Rd, Tucker, GA 30084 Phone: 770-718-1517 |
Nathan Lee Potter, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4017 Northlake Creek Dr, Tucker, GA 30084 Phone: 317-501-9558 |
Michael L Werner, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1491 Montreal Rd, Tucker, GA 30084 Phone: 770-270-1284 |
Brianna Monique Molina, Physician Assistant Medicare: Medicare Enrolled Practice Location: 2227 Idlewood Rd Ste 1, Tucker, GA 30084 Phone: 678-205-2039 |
Elissa Ann Stanton, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 3987 Brown Rd, Tucker, GA 30084 Phone: 770-689-8936 |
Marissa Weiching Goolsby, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4650 Hugh Howell Rd Ste 510, Tucker, GA 30084 Phone: 678-956-8630 Fax: 678-956-8634 |
Britney Jane Yates, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4865 Lavista Rd Ste A, Tucker, GA 30084 Phone: 770-442-1911 |