| Marlon Bonner, | |
|
810 Kirkly Way, Fairburn, GA 30213-2482 | |
| (706) 332-9395 | |
| Not Available |
| Full Name | Marlon Bonner |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology Assistant |
| Experience | 11 Years |
| Location | 810 Kirkly Way, Fairburn, 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 |
|---|---|---|---|
| 1225442734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367H00000X | Anesthesiologist Assistant | (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Wellstar Douglas Hospital | Douglasville, GA | Hospital |
| Wellstar Kennestone Hospital | Marietta, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wellstar Medical Group Llc | 6709065402 | 2734 |
| Grady Memorial Hospital Corporation | 7517032998 | 311 |
| 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 | Georgia Anesthesiologists, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740299197 PECOS PAC ID: 7315835063 Enrollment ID: O20040305000398 |
| Entity Name | Grady Memorial Hospital Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114243813 PECOS PAC ID: 7517032998 Enrollment ID: O20100723000311 |
| Entity Name | Concordia Anesthesiology Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619296464 PECOS PAC ID: 8325172885 Enrollment ID: O20100819000220 |
| 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 |
| Mailing Address | Practice Location Address |
|---|---|
| Marlon Bonner, 810 Kirkly Way, Fairburn, GA 30213-2482 Ph: (706) 332-9395 | Marlon Bonner, 810 Kirkly Way, Fairburn, GA 30213-2482 Ph: (706) 332-9395 |