| Dx Mso Of Georgia Llc | |
|
1302 W Walnut Ave Ste 1 Dalton GA 30720-3827 | |
| (423) 476-5990 | |
| (423) 476-5887 |
| Full Name | Dx Mso Of Georgia Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1302 W Walnut Ave Ste 1, Dalton, Georgia |
| Authorized Official Name and Position | Charles Todd Rudolph (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4233225050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dx Mso Of Georgia Llc 1025 Peerless Crossing Nw Cleveland TN 37312-3764 Ph: (423) 476-5990 | Dx Mso Of Georgia Llc 1302 W Walnut Ave Ste 1 Dalton GA 30720-3827 Ph: (423) 476-5990 |
| NPI Number | 1922757111 |
|---|---|
| Provider Enumeration Date | 03/23/2022 |
| Last Update Date | 07/08/2026 |
| Medicare PECOS PAC ID | 1153702931 |
|---|---|
| Medicare Enrollment ID | O20220726000839 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922757111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | George E Aristide |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720030919 PECOS PAC ID: 8527010248 Enrollment ID: I20050210000593 |
| Provider Name | Richard Mersberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336198969 PECOS PAC ID: 1759310956 Enrollment ID: I20050808001140 |
| Provider Name | Natasha Elizabeth Ballard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023288743 PECOS PAC ID: 7214078377 Enrollment ID: I20100112000125 |
| Provider Name | Tara A Sane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417204132 PECOS PAC ID: 8022267061 Enrollment ID: I20121005000537 |
| Provider Name | Terriest Haire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891815106 PECOS PAC ID: 0345540506 Enrollment ID: I20200320001570 |
| Provider Name | Sarah E Steele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003456815 PECOS PAC ID: 4082020052 Enrollment ID: I20210317001770 |
| Provider Name | Arthur Mckinish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972185999 PECOS PAC ID: 2769870443 Enrollment ID: I20211029000275 |
| Provider Name | Lacy Wilkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821729252 PECOS PAC ID: 4183005903 Enrollment ID: I20220725002241 |
| Provider Name | Heather Tinker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033730130 PECOS PAC ID: 1951710813 Enrollment ID: I20220728000544 |
| Provider Name | Charles Todd Rudolph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346351673 PECOS PAC ID: 4284685678 Enrollment ID: I20220825002817 |
| Provider Name | Jonathan D Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104553924 PECOS PAC ID: 0042680647 Enrollment ID: I20221222001685 |
| Provider Name | Nicki D. Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609275049 PECOS PAC ID: 1052532504 Enrollment ID: I20230811002981 |
| Provider Name | Karen Lolley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013446426 PECOS PAC ID: 6901251024 Enrollment ID: I20231019002909 |
| Provider Name | Brittany B Bossert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144664301 PECOS PAC ID: 0446471155 Enrollment ID: I20240130001611 |
| Provider Name | Jessi Steve |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922380534 PECOS PAC ID: 1759554512 Enrollment ID: I20240222000551 |
| Provider Name | Joseph Cihlar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871926246 PECOS PAC ID: 5496070872 Enrollment ID: I20241217002801 |
| Provider Name | Johnna S Abbasi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508331505 PECOS PAC ID: 9830425503 Enrollment ID: I20250121002890 |
Griggs Family Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1301 Broadrick Dr, Dalton, GA 30720 Phone: 706-529-4266 Fax: 706-529-4269 | |
Mednow, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2709 Airport Rd, Suite 101, Dalton, GA 30721 Phone: 706-275-4444 Fax: 706-275-6515 | |
I D Specialist Dalton P C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 E Walnut Ave Ste 4, Dalton, GA 30721 Phone: 706-428-8908 | |
Homestead Hospice Of Northwest Georgia, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1209 Starr Dr, Dalton, GA 30720 Phone: 706-217-1926 Fax: 706-217-1927 | |
The Deo Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 218 N Fredrick St, Dalton, GA 30721 Phone: 706-581-2009 Fax: 706-529-5055 | |
Premise Health Of Georgia Medical, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2305 Abutment Rd, Dalton, GA 30721 Phone: 706-532-2588 Fax: 706-532-2589 | |
Mc Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 815 Shugart Rd, Dalton, GA 30720 Phone: 706-277-7661 Fax: 706-277-7669 |