| John Michael Dorough, AA | |
|
161 Raymonds Grant Trce, Saint Simons Island, GA 31522-5393 | |
| (912) 638-9734 | |
| Not Available |
| Full Name | John Michael Dorough |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology Assistant |
| Experience | 38 Years |
| Location | 161 Raymonds Grant Trce, Saint Simons Island, 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 |
|---|---|---|---|
| 1063460236 | NPI | - | NPPES |
| 100001809A | Medicaid | GA | |
| 100001811B | Medicaid | GA | |
| P00410144 | Other | GA | RRB |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 001777 (Georgia) | Primary |
| 367H00000X | Anesthesiologist Assistant | AA91 (Florida) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| John D Archbold Memorial Hospital | Thomasville, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| South Georgia Anesthesia Associates, Pc | 1759349830 | 26 |
| Entity Name | Tift Regional Health System, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790280857 PECOS PAC ID: 5193619971 Enrollment ID: O20040212000064 |
| Entity Name | Piedmont Anesthesia Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407856594 PECOS PAC ID: 3577457183 Enrollment ID: O20040212000604 |
| Entity Name | South Georgia Anesthesia Associates, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285605733 PECOS PAC ID: 1759349830 Enrollment ID: O20041221000350 |
| Mailing Address | Practice Location Address |
|---|---|
| John Michael Dorough, AA 161 Raymonds Grant Trce, Saint Simons Island, GA 31522-5393 Ph: (912) 571-0808 | John Michael Dorough, AA 161 Raymonds Grant Trce, Saint Simons Island, GA 31522-5393 Ph: (912) 638-9734 |
Mrs. Elizabeth Y Fletcher, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 106 Retreat Vlg, Saint Simons Island, GA 31522 Phone: 912-434-9316 Fax: 912-357-1401 | |
Heather Suzanne Brock, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 100 Saint Clair Pkwy, Saint Simons Island, GA 31522 Phone: 678-446-7351 |