| Ecc Hospitalist Services Pc | |
|
501 Redmond Rd Nw Rome GA 30165-1415 | |
| (706) 802-3018 | |
| Not Available |
| Full Name | Ecc Hospitalist Services Pc |
|---|---|
| Speciality | Hospitalist |
| Location | 501 Redmond Rd Nw, Rome, Georgia |
| Authorized Official Name and Position | Randal L. Dabbs (PRESIDENT) |
| Authorized Official Contact | 8652935210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ecc Hospitalist Services Pc Po Box 635722 Cincinnati OH 45263-0001 Ph: (888) 203-1274 | Ecc Hospitalist Services Pc 501 Redmond Rd Nw Rome GA 30165-1415 Ph: (706) 802-3018 |
| NPI Number | 1710108170 |
|---|---|
| Provider Enumeration Date | 05/02/2007 |
| Last Update Date | 09/26/2019 |
| Medicare PECOS PAC ID | 2567563356 |
|---|---|
| Medicare Enrollment ID | O20070724000176 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710108170 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Tennessee) | Secondary |
| 208M00000X | Hospitalist | (Tennessee) | Primary |
| Provider Name | Fakhar Ahmad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1295781094 PECOS PAC ID: 4587636022 Enrollment ID: I20040806000339 |
| Provider Name | Brian T Keefe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295721629 PECOS PAC ID: 9830187350 Enrollment ID: I20050928000178 |
| Provider Name | Ingrid Tanubrata |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659394542 PECOS PAC ID: 8820098726 Enrollment ID: I20061227000108 |
| Provider Name | Perry M Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922168103 PECOS PAC ID: 3173525672 Enrollment ID: I20070213000553 |
| Provider Name | Amarabalan Rajendran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962843680 PECOS PAC ID: 8224323134 Enrollment ID: I20160817000063 |
| Provider Name | Cynthia Griffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790170371 PECOS PAC ID: 6103120092 Enrollment ID: I20160928001415 |
| Provider Name | Abhijit R Kanthala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730443383 PECOS PAC ID: 6901179357 Enrollment ID: I20170906001940 |
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