| Alpha Internal Medicine, Llc | |
|
745 Glynn St S Fayetteville GA 30214-2049 | |
| (770) 719-5490 | |
| Not Available |
| Full Name | Alpha Internal Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 745 Glynn St S, Fayetteville, Georgia |
| Authorized Official Name and Position | Betsy S Horton (PRESIDENT) |
| Authorized Official Contact | 7707195490 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpha Internal Medicine, Llc Po Box 142459 Fayetteville GA 30214-6515 Ph: (770) 719-5490 | Alpha Internal Medicine, Llc 745 Glynn St S Fayetteville GA 30214-2049 Ph: (770) 719-5490 |
| NPI Number | 1083622849 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 04/01/2014 |
| Medicare PECOS PAC ID | 2961398185 |
|---|---|
| Medicare Enrollment ID | O20040225000321 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083622849 | NPI | - | NPPES |
| 00753519B | Medicaid | GA | |
| 510368765A | Medicaid | GA |
| Provider Name | Donna Michelle Haney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497821862 PECOS PAC ID: 3072583913 Enrollment ID: I20040729000189 |
| Provider Name | Monica O Watts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043356355 PECOS PAC ID: 9335192400 Enrollment ID: I20050301000496 |
| Provider Name | Carl J Cooper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699725713 PECOS PAC ID: 0941268643 Enrollment ID: I20051214000108 |
| Provider Name | Loida Bonney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316998982 PECOS PAC ID: 6305862665 Enrollment ID: I20070627000066 |
| Provider Name | Carol A Pisarello |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679577019 PECOS PAC ID: 8123129772 Enrollment ID: I20070726000110 |
| Provider Name | Melissa D. Primrose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457496234 PECOS PAC ID: 7012004435 Enrollment ID: I20071101000531 |
| Provider Name | Betsy Susan Horton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932153780 PECOS PAC ID: 9830085059 Enrollment ID: I20100519000016 |
| Provider Name | Andrew J Malinchak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700810116 PECOS PAC ID: 7810189743 Enrollment ID: I20101011000011 |
| Provider Name | Michele Asa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922376417 PECOS PAC ID: 5294986584 Enrollment ID: I20121114000363 |
| Provider Name | David C Rowan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366763070 PECOS PAC ID: 4385892728 Enrollment ID: I20130619000432 |
| Provider Name | Melinda Chavis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841628583 PECOS PAC ID: 6406082767 Enrollment ID: I20131115001244 |
| Provider Name | Todd W Deavens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467749176 PECOS PAC ID: 8426206392 Enrollment ID: I20150410001017 |
| Provider Name | Corby L. Barkhaus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841680048 PECOS PAC ID: 7113245127 Enrollment ID: I20150422001893 |
| Provider Name | Kristina D Harpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497295083 PECOS PAC ID: 1658646955 Enrollment ID: I20171012003253 |
| Provider Name | Jae Youn Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720519283 PECOS PAC ID: 1951652502 Enrollment ID: I20180921000282 |
| Provider Name | Andrew Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790305746 PECOS PAC ID: 9739506437 Enrollment ID: I20200826001760 |
| Provider Name | Jana Ludwig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740860527 PECOS PAC ID: 6002206497 Enrollment ID: I20211129000696 |
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