| Seth Monroe Park, PA | |
|
4155 Baker St Ne Ste 100, Covington, GA 30014-1405 | |
| (770) 788-0620 | |
| Not Available |
| Full Name | Seth Monroe Park |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 4155 Baker St Ne Ste 100, Covington, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730650144 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 9020 (Georgia) | Primary |
| Entity Name | The Derm Center of Newton |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679682561 PECOS PAC ID: 7810935012 Enrollment ID: O20050419000724 |
| Mailing Address | Practice Location Address |
|---|---|
| Seth Monroe Park, PA 4155 Baker St Ne Ste 100, Covington, GA 30014-1405 Ph: (770) 788-0620 | Seth Monroe Park, PA 4155 Baker St Ne Ste 100, Covington, GA 30014-1405 Ph: (770) 788-0620 |
Mr. Juriaan Martijn Van Der Heijden, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5303 Adams St Ne Ste A, Covington, GA 30014 Phone: 770-554-5009 |
Ashley E Heath, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 4155 Baker Street Ne, Suite 100, Covington, GA 30014 Phone: 770-788-0620 Fax: 678-342-3327 |
Mrs. Tiffany Blamble, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4181 Hospital Dr Ne Ste 204, Covington, GA 30014 Phone: 770-788-6534 |
Shelby Boggus King, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4181 Hospital Drive Ne, Suite 204, Covington, GA 30014 Phone: 770-788-6534 |
Mr. Jace John Crawford, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5126 Hospital Dr Ne, Covington, GA 30014 Phone: 770-786-7053 |
Quincy Wudias Goodwin, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5126 Hospital Dr Ne, Covington, GA 30014 Phone: 770-607-7339 |
Ryan Kyle Smith, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5126 Hospital Dr Ne, Covington, GA 30014 Phone: 800-532-6151 |