| Logan Balkcom, | |
|
901 18th St E, Tifton, GA 31794-3648 | |
| (229) 382-7120 | |
| Not Available |
| Full Name | Logan Balkcom |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology Assistant |
| Experience | 4 Years |
| Location | 901 18th St E, Tifton, 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 |
|---|---|---|---|
| 1891457768 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367H00000X | Anesthesiologist Assistant | 10709 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Tift Regional Medical Center | Tifton, GA | Hospital |
| Cook Medical Center A Campus Of Tift Reg Med Ctr | Adel, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Tift Regional Health System Inc | 2062745169 | 262 |
| Entity Name | Tift Regional Health System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881203305 PECOS PAC ID: 2062745169 Enrollment ID: O20200217002409 |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Balkcom, 901 18th St E, Tifton, GA 31794-3648 Ph: (229) 382-7120 | Logan Balkcom, 901 18th St E, Tifton, GA 31794-3648 Ph: (229) 382-7120 |
Lacey Jackson Landon, AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 901 18th St E, Tifton, GA 31794 Phone: 229-382-7120 | |
Clinton Jeffery Brown, AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 901 18th St E, Tifton, GA 31794 Phone: 229-353-6208 Fax: 229-353-7722 | |
Mr. Manuel Chavez Jr., CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 901 18th St E, Tifton, GA 31794 Phone: 229-353-7050 | |
Mr. Ian Michael Hester, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 901 18th St E, Tifton, GA 31794 Phone: 229-382-7120 |