| Liam Samuel Groseclose, | |
|
1700 Mulkey Rd, Austell, GA 30106-1116 | |
| (770) 941-5750 | |
| Not Available |
| Full Name | Liam Samuel Groseclose |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 8 Years |
| Location | 1700 Mulkey Rd, Austell, 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 |
|---|---|---|---|
| 1609376763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | RN223393 (Georgia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Pruitthealth Physicians Services Llc | 8123327061 | 11 |
| 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 |
| Entity Name | Pruitthealth Physicians Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043676299 PECOS PAC ID: 8123327061 Enrollment ID: O20160428000256 |
| Mailing Address | Practice Location Address |
|---|---|
| Liam Samuel Groseclose, 3576 S Sherwood Rd Se, Smyrna, GA 30082-2832 Ph: (678) 522-1963 | Liam Samuel Groseclose, 1700 Mulkey Rd, Austell, GA 30106-1116 Ph: (770) 941-5750 |
Mrs. Kelsey Irene Fortier, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1605 Mulkey Rd, Suite 220, Austell, GA 30106 Phone: 470-956-3760 | |
Manuel Piri, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1676 Mulkey Rd, Suite A, Austell, GA 30106 Phone: 678-838-6600 Fax: 678-838-6602 | |
Ms. Kristin L Faine, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 800 E West Connector, Austell, GA 30106 Phone: 770-438-1680 | |
Takiyah Johnson Turks, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1625 Hospital North Dr Ste 150, Austell, GA 30106 Phone: 470-732-6950 Fax: 770-739-0138 | |
Dr. Latoya Katrese Buford, DNP, APRN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 800 E West Connector, Austell, GA 30106 Phone: 866-389-2727 | |
Elizabeth Bilfinger Hill, AGPCNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3825 Medical Park Dr Ste 100, Austell, GA 30106 Phone: 770-948-5578 | |
Kewana Craig, MSN, APRN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 800 E West Connector, Austell, GA 30106 Phone: 866-389-2727 |