| Southeast Georgia Physician Associates | |
|
2415 Parkwood Dr Brunswick GA 31520-4722 | |
| (912) 466-7000 | |
| (912) 466-5091 |
| Full Name | Southeast Georgia Physician Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 2415 Parkwood Dr, Brunswick, Georgia |
| Authorized Official Name and Position | Michael David Scherneck (PRESIDENT & CEO) |
| Authorized Official Contact | 9124667049 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Georgia Physician Associates 2415 Parkwood Dr Brunswick GA 31520-4722 Ph: (912) 466-7000 | Southeast Georgia Physician Associates 2415 Parkwood Dr Brunswick GA 31520-4722 Ph: (912) 466-7000 |
| NPI Number | 1417979402 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 06/18/2021 |
| Medicare PECOS PAC ID | 9830093640 |
|---|---|
| Medicare Enrollment ID | O20031124000222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417979402 | NPI | - | NPPES |
| Provider Name | James M Muse |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679652762 PECOS PAC ID: 4082516901 Enrollment ID: I20040122000263 |
| Provider Name | Martin R Artman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104890284 PECOS PAC ID: 2163318601 Enrollment ID: I20040223001084 |
| Provider Name | Jason M Dancy |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1982643706 PECOS PAC ID: 0446148027 Enrollment ID: I20040305000664 |
| Provider Name | Elizabeth J Sudduth |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1417020272 PECOS PAC ID: 8820986706 Enrollment ID: I20040310001127 |
| Provider Name | Eric J Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063425817 PECOS PAC ID: 0648264283 Enrollment ID: I20040414001197 |
| Provider Name | Thomas Campen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497729834 PECOS PAC ID: 0547251944 Enrollment ID: I20040524000764 |
| Provider Name | Margaret A Carter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184638702 PECOS PAC ID: 6103808258 Enrollment ID: I20040603000235 |
| Provider Name | Terry L Reynolds |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912997859 PECOS PAC ID: 6901881242 Enrollment ID: I20040622000187 |
| Provider Name | Sally Horne |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215040381 PECOS PAC ID: 5395723605 Enrollment ID: I20040713000362 |
| Provider Name | John Johnston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649241894 PECOS PAC ID: 9436133865 Enrollment ID: I20040816000100 |
| Provider Name | Mary L Carter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427000165 PECOS PAC ID: 7719951334 Enrollment ID: I20040824000421 |
| Provider Name | James S Snow |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467405274 PECOS PAC ID: 1951362227 Enrollment ID: I20041020000574 |
| Provider Name | Elizabeth K Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063501757 PECOS PAC ID: 0143208264 Enrollment ID: I20041020000806 |
| Provider Name | Randolph C Bishop |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1659360600 PECOS PAC ID: 0547226334 Enrollment ID: I20041203000197 |
| Provider Name | William T Garrett |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750351862 PECOS PAC ID: 4385601046 Enrollment ID: I20041214000726 |
| Provider Name | Bruce G Tripp |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1982661641 PECOS PAC ID: 7315904620 Enrollment ID: I20041220000539 |
| Provider Name | Timothy A Jamieson |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1548251010 PECOS PAC ID: 4688631997 Enrollment ID: I20041220000719 |
| Provider Name | Enrique J. Fernandez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912978065 PECOS PAC ID: 2264490077 Enrollment ID: I20041229000015 |
| Provider Name | Marsha J Certain |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1144252735 PECOS PAC ID: 2163470469 Enrollment ID: I20050104000153 |
| Provider Name | Avery W Strickland |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043238470 PECOS PAC ID: 5597713891 Enrollment ID: I20050104000169 |
| Provider Name | Mitchell T Jones |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952329385 PECOS PAC ID: 4587612882 Enrollment ID: I20050104000177 |
| Provider Name | Ashley W Lezotte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114247921 PECOS PAC ID: 5890743108 Enrollment ID: I20050104000235 |
| Provider Name | Turner W Rentz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538122833 PECOS PAC ID: 0143272831 Enrollment ID: I20050215000985 |
| Provider Name | Walter L Hicks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477626232 PECOS PAC ID: 7315990538 Enrollment ID: I20050301000091 |
| Provider Name | Francisco Fantauzzi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821161688 PECOS PAC ID: 0648225888 Enrollment ID: I20050321000523 |
| Provider Name | Scott C Clay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003901117 PECOS PAC ID: 7911945779 Enrollment ID: I20050421000749 |
| Provider Name | Thomas Sasser |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1174533814 PECOS PAC ID: 2062454358 Enrollment ID: I20050526000435 |
| Provider Name | Mitchell V Brock |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568488435 PECOS PAC ID: 3476580606 Enrollment ID: I20050720000150 |
| Provider Name | Darrin A Strickland |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174549042 PECOS PAC ID: 8628006178 Enrollment ID: I20050727000440 |
| Provider Name | David C Whitehead |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962403766 PECOS PAC ID: 7517948573 Enrollment ID: I20050822000427 |
| Provider Name | Iris L Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558434316 PECOS PAC ID: 8921039470 Enrollment ID: I20050825000102 |
| Provider Name | John A Limburg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013900604 PECOS PAC ID: 5890737233 Enrollment ID: I20050907000735 |
| Provider Name | Babajide Falana |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003867334 PECOS PAC ID: 1456379775 Enrollment ID: I20051104000691 |
| Provider Name | Janice K Bain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093704645 PECOS PAC ID: 6305864174 Enrollment ID: I20051110000078 |
| Provider Name | Daniel L Miller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922171784 PECOS PAC ID: 8022040872 Enrollment ID: I20051129000262 |
| Provider Name | Robert H Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740353507 PECOS PAC ID: 6507898434 Enrollment ID: I20051130000361 |
| Provider Name | Thomas Whitesell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245231984 PECOS PAC ID: 4981625217 Enrollment ID: I20051214000099 |
| Provider Name | Abraham Cheong |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1285624882 PECOS PAC ID: 1951317072 Enrollment ID: I20060228000056 |
| Provider Name | Colman David Sudduth |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1851387310 PECOS PAC ID: 7911915301 Enrollment ID: I20060327000481 |
| Provider Name | Herman Levy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1184610313 PECOS PAC ID: 8527072008 Enrollment ID: I20060327000498 |
| Provider Name | Sherman A Stevenson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1316935000 PECOS PAC ID: 7517975485 Enrollment ID: I20060404000403 |
| Provider Name | Lloyd G Geddes |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1730193046 PECOS PAC ID: 2961411186 Enrollment ID: I20060418000066 |
| Provider Name | Alan K Brown |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275590481 PECOS PAC ID: 6608841580 Enrollment ID: I20060802000309 |
| Provider Name | Alicia S Hodge |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720036411 PECOS PAC ID: 8325041213 Enrollment ID: I20060815000118 |
| Provider Name | Shirley D Wilson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790711851 PECOS PAC ID: 6901809516 Enrollment ID: I20060822000301 |
| Provider Name | Margaret Hartnett-goodman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306860788 PECOS PAC ID: 5193720985 Enrollment ID: I20060929000308 |
| Provider Name | Stephen A Chitty |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1902895824 PECOS PAC ID: 0244278695 Enrollment ID: I20061120000003 |
| Provider Name | Gary Fischer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053427690 PECOS PAC ID: 6103846282 Enrollment ID: I20070206000147 |
| Provider Name | Elizabeth A Bulatao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992888754 PECOS PAC ID: 5395842876 Enrollment ID: I20070517000311 |
| Provider Name | Kim T Baird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790755585 PECOS PAC ID: 2769589241 Enrollment ID: I20070517000323 |
| Provider Name | Joseph A Lanzone |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1073692174 PECOS PAC ID: 6103710892 Enrollment ID: I20070615000039 |
| Provider Name | Trent A Schueneman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164484911 PECOS PAC ID: 5597866202 Enrollment ID: I20070725000389 |
| Provider Name | Michael J Sullivan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255341988 PECOS PAC ID: 1052353323 Enrollment ID: I20070802000232 |
| Provider Name | Jack M Deese |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124038856 PECOS PAC ID: 3678546157 Enrollment ID: I20070802000264 |
| Provider Name | Denny A Carter |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396755039 PECOS PAC ID: 3173614302 Enrollment ID: I20070802000277 |
| Provider Name | Katherine L Maurath |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1366452013 PECOS PAC ID: 2163513391 Enrollment ID: I20070802000293 |
| Provider Name | Cassandra C Latham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568513869 PECOS PAC ID: 4688768849 Enrollment ID: I20070919000065 |
| Provider Name | Vivian L Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912089590 PECOS PAC ID: 6901988492 Enrollment ID: I20080123000286 |
| Provider Name | James F Gowen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366484255 PECOS PAC ID: 0143303396 Enrollment ID: I20080211000495 |
| Provider Name | Harriet E Witt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447258843 PECOS PAC ID: 0941281661 Enrollment ID: I20080422000389 |
| Provider Name | Andrew D Magnet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063411601 PECOS PAC ID: 7911000518 Enrollment ID: I20080520000229 |
| Provider Name | Antonio Moran |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1396735908 PECOS PAC ID: 3779655139 Enrollment ID: I20080701000205 |
| Provider Name | Janise H Whitesell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154322899 PECOS PAC ID: 2668545609 Enrollment ID: I20080723000815 |
| Provider Name | Brandi M Wynne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316152770 PECOS PAC ID: 2466528849 Enrollment ID: I20080909000323 |
| Provider Name | John M Blumer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619984150 PECOS PAC ID: 3971661315 Enrollment ID: I20081029000183 |
| Provider Name | Kenyon M Meadows |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1891726451 PECOS PAC ID: 0749286136 Enrollment ID: I20081121000464 |
| Provider Name | Shenon E Badre |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1407929276 PECOS PAC ID: 9335200427 Enrollment ID: I20081208000537 |
| Provider Name | Lemuel G Villanueva |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336107978 PECOS PAC ID: 1153499967 Enrollment ID: I20090203000460 |
| Provider Name | Cynthia J Westberry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942495833 PECOS PAC ID: 5890844674 Enrollment ID: I20090527000578 |
| Provider Name | Robert D Mixson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912904459 PECOS PAC ID: 0244381846 Enrollment ID: I20090622000274 |
| Provider Name | Misty Williams |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932116209 PECOS PAC ID: 5092744367 Enrollment ID: I20091022000006 |
| Provider Name | Tammy M Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861550865 PECOS PAC ID: 0244256196 Enrollment ID: I20091022000009 |
| Provider Name | David L Lawson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427064484 PECOS PAC ID: 2668511460 Enrollment ID: I20091208000717 |
| Provider Name | Frank Robert Kohler |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1356432090 PECOS PAC ID: 6608948336 Enrollment ID: I20100115000267 |
| Provider Name | George Mccaskill |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689619678 PECOS PAC ID: 3971589656 Enrollment ID: I20100125000123 |
| Provider Name | Vincent K Arlauskas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1841357563 PECOS PAC ID: 2365514734 Enrollment ID: I20100226000020 |
| Provider Name | Eric C Segerberg |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558428326 PECOS PAC ID: 4082717624 Enrollment ID: I20100304000080 |
| Provider Name | Stephen G Barrett |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609933308 PECOS PAC ID: 0749325504 Enrollment ID: I20100304000110 |
| Provider Name | William Joseph Kolhoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669703278 PECOS PAC ID: 7416085790 Enrollment ID: I20100506000543 |
| Provider Name | Paul Kevin Beach |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1770672982 PECOS PAC ID: 0244374122 Enrollment ID: I20100526000647 |
| Provider Name | Duane P Moores |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1598755191 PECOS PAC ID: 2769554260 Enrollment ID: I20100621000449 |
| Provider Name | James J Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033118880 PECOS PAC ID: 4688632722 Enrollment ID: I20100819000846 |
| Provider Name | Steven T Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316132202 PECOS PAC ID: 4587788476 Enrollment ID: I20100830000511 |
| Provider Name | David W Heine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750397899 PECOS PAC ID: 9436341294 Enrollment ID: I20101012000526 |
| Provider Name | Randolph M Baker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265448310 PECOS PAC ID: 3072706522 Enrollment ID: I20101018000426 |
| Provider Name | Shonna L Mcgee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245425149 PECOS PAC ID: 6406040716 Enrollment ID: I20101101000560 |
| Provider Name | Karla K Hansen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1326159120 PECOS PAC ID: 8325232382 Enrollment ID: I20101103000874 |
| Provider Name | Joseph H Bee |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1942431408 PECOS PAC ID: 8325232390 Enrollment ID: I20101103000971 |
| Provider Name | Damon W Brantley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902868011 PECOS PAC ID: 5193779924 Enrollment ID: I20101115000090 |
| Provider Name | Michele M Mcmahon |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427156900 PECOS PAC ID: 9234210394 Enrollment ID: I20101230000561 |
| Provider Name | Kimberly S Brown |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1205829009 PECOS PAC ID: 3577516954 Enrollment ID: I20110112000814 |
| Provider Name | Steven F Mosher |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1205837150 PECOS PAC ID: 3274612650 Enrollment ID: I20110113001039 |
| Provider Name | William J Laws |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316951619 PECOS PAC ID: 5395924229 Enrollment ID: I20110125000627 |
| Provider Name | Sinnathurai Vasanthakumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598714479 PECOS PAC ID: 3779763958 Enrollment ID: I20110204000362 |
| Provider Name | John E Shaner |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1285624411 PECOS PAC ID: 3779479514 Enrollment ID: I20110504000094 |
| Provider Name | Deborah Lindahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114223690 PECOS PAC ID: 1254517360 Enrollment ID: I20110525000104 |
| Provider Name | Lori Trefts |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306875117 PECOS PAC ID: 8628075892 Enrollment ID: I20110826000473 |
| Provider Name | Angela P Highbaugh Battle |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336261916 PECOS PAC ID: 3375644172 Enrollment ID: I20110829000404 |
| Provider Name | Daniel Dino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326248105 PECOS PAC ID: 5799955613 Enrollment ID: I20110901000721 |
| Provider Name | Jeong Sok Seo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639359342 PECOS PAC ID: 1456521012 Enrollment ID: I20110909002445 |
| Provider Name | Robin A Rittgers |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588659973 PECOS PAC ID: 4082885322 Enrollment ID: I20110919000484 |
| Provider Name | Darrell E Schwerther |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1952396350 PECOS PAC ID: 6406028059 Enrollment ID: I20111004000576 |
| Provider Name | Huitt E Mattox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548255920 PECOS PAC ID: 9234169749 Enrollment ID: I20111213000081 |
| Provider Name | Whitney B Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194009514 PECOS PAC ID: 3870768005 Enrollment ID: I20111215000888 |
| Provider Name | Nathan A Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659649606 PECOS PAC ID: 7315113024 Enrollment ID: I20111230000217 |
| Provider Name | James A Wilson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669441903 PECOS PAC ID: 9931376399 Enrollment ID: I20120125000760 |
| Provider Name | Lisia A Sullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609937499 PECOS PAC ID: 2062672637 Enrollment ID: I20120320000402 |
| Provider Name | David Michael Kranc |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1649267790 PECOS PAC ID: 0547272064 Enrollment ID: I20120404000680 |
| Provider Name | Marion E Alston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801166749 PECOS PAC ID: 2567623481 Enrollment ID: I20120419000456 |
| Provider Name | Rudolf G Nunnemann |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1053308262 PECOS PAC ID: 2365454881 Enrollment ID: I20120504000323 |
| Provider Name | Daniel Eli Penn |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1528143377 PECOS PAC ID: 5698939445 Enrollment ID: I20120607000502 |
| Provider Name | Jason M Joseph |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356550610 PECOS PAC ID: 6002070455 Enrollment ID: I20120614000376 |
| Provider Name | Cheryl S O Donoghue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194081521 PECOS PAC ID: 6507020955 Enrollment ID: I20120614000435 |
| Provider Name | Claude Levon Sanks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023242179 PECOS PAC ID: 5991961476 Enrollment ID: I20120727000479 |
| Provider Name | Eric Eskioglu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336222900 PECOS PAC ID: 5890714976 Enrollment ID: I20120815000739 |
| Provider Name | John Sarzier |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1306808191 PECOS PAC ID: 5698741346 Enrollment ID: I20120820000662 |
| Provider Name | Wesley H Faunce |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1003878877 PECOS PAC ID: 3173609336 Enrollment ID: I20120827000369 |
| Provider Name | Douglas F Savage |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1801859202 PECOS PAC ID: 7416914379 Enrollment ID: I20120827000383 |
| Provider Name | Olayinka A Elesha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083887954 PECOS PAC ID: 8729237391 Enrollment ID: I20120926000357 |
| Provider Name | Donald J. Moyer |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1851354179 PECOS PAC ID: 2264566272 Enrollment ID: I20121003000514 |
| Provider Name | William R Alexander |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639303589 PECOS PAC ID: 7810146859 Enrollment ID: I20121005000453 |
| Provider Name | Janice P Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053660738 PECOS PAC ID: 1658520416 Enrollment ID: I20121011000337 |
| Provider Name | Patricia I Chimezie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861629651 PECOS PAC ID: 6709036973 Enrollment ID: I20121024000346 |
| Provider Name | Cynthia S Wallace |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1528257268 PECOS PAC ID: 1557515525 Enrollment ID: I20130129000614 |
| Provider Name | Atrac A Kay |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811188006 PECOS PAC ID: 4981849908 Enrollment ID: I20130322000291 |
| Provider Name | Shelley Street Callender |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184773939 PECOS PAC ID: 7618979196 Enrollment ID: I20130611000335 |
| Provider Name | Charles W Callender |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1972576320 PECOS PAC ID: 6709931470 Enrollment ID: I20130613000257 |
| Provider Name | Stephen Anthony Nickisch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578596615 PECOS PAC ID: 0042114514 Enrollment ID: I20130702000576 |
| Provider Name | Robert K Oldham |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1548255334 PECOS PAC ID: 5890880876 Enrollment ID: I20130711000740 |
| Provider Name | Karen Jean Terrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245675198 PECOS PAC ID: 6608016209 Enrollment ID: I20130723000971 |
| Provider Name | Renee Lizette Lewis-kensah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043535933 PECOS PAC ID: 3779724893 Enrollment ID: I20130731000808 |
| Provider Name | Amy L. Carrington |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336468867 PECOS PAC ID: 4486896347 Enrollment ID: I20130806000740 |
| Provider Name | Ana Ingeborg Tejero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043422629 PECOS PAC ID: 0749325934 Enrollment ID: I20130827000543 |
| Provider Name | Muhammad S Afridi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902169741 PECOS PAC ID: 0840430856 Enrollment ID: I20130828000941 |
| Provider Name | Kemisha L Key |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487975132 PECOS PAC ID: 8022243153 Enrollment ID: I20131028000497 |
| Provider Name | Nicole A Hiller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497083125 PECOS PAC ID: 3476788175 Enrollment ID: I20131106000167 |
| Provider Name | Robyn N Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588092910 PECOS PAC ID: 8325274871 Enrollment ID: I20131112000695 |
| Provider Name | Francois R. Roche |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760795108 PECOS PAC ID: 1557485877 Enrollment ID: I20131125000697 |
| Provider Name | Nancy A Denlea |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902874043 PECOS PAC ID: 7012143928 Enrollment ID: I20131125001313 |
| Provider Name | Lesli G Mcquigg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851664445 PECOS PAC ID: 8729214549 Enrollment ID: I20131126000574 |
| Provider Name | Donna Hooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083053045 PECOS PAC ID: 3072742964 Enrollment ID: I20140219001243 |
| Provider Name | Levinchi Oglesby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265861439 PECOS PAC ID: 3072743327 Enrollment ID: I20140305002074 |
| Provider Name | Samantha R Meeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508870460 PECOS PAC ID: 0345231536 Enrollment ID: I20140421001705 |
| Provider Name | Shontae Renee Buffington |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083729446 PECOS PAC ID: 3476736208 Enrollment ID: I20140516001011 |
| Provider Name | Matthew Edward Certain |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1760669865 PECOS PAC ID: 5395968762 Enrollment ID: I20140603002678 |
| Provider Name | Valerie M Gironda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073834123 PECOS PAC ID: 7517183122 Enrollment ID: I20140716002102 |
| Provider Name | Renny V Peter |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578889556 PECOS PAC ID: 3870729049 Enrollment ID: I20140909002353 |
| Provider Name | Fiona C Kehoe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427344753 PECOS PAC ID: 3375790157 Enrollment ID: I20140916002208 |
| Provider Name | Walter G Floyd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437445764 PECOS PAC ID: 5193972974 Enrollment ID: I20140916002375 |
| Provider Name | Erich S Pearson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629380753 PECOS PAC ID: 9830371848 Enrollment ID: I20140924002492 |
| Provider Name | Tyler A Clark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578850475 PECOS PAC ID: 8325268352 Enrollment ID: I20140925001397 |
| Provider Name | Phillip Amodeo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609064146 PECOS PAC ID: 8820112923 Enrollment ID: I20141016001939 |
| Provider Name | Anthony J Vaz |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1417922469 PECOS PAC ID: 1759318215 Enrollment ID: I20141112001278 |
| Provider Name | Maisara Kobaisy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841590908 PECOS PAC ID: 2062738297 Enrollment ID: I20150306000980 |
| Provider Name | Matthew J Todd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841209632 PECOS PAC ID: 1557322138 Enrollment ID: I20150323002361 |
| Provider Name | Matthew D Katz |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033258074 PECOS PAC ID: 5890893812 Enrollment ID: I20150324000989 |
| Provider Name | John W. Tsai |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104972223 PECOS PAC ID: 1951572171 Enrollment ID: I20150326001015 |
| Provider Name | Christopher C Ezeihuaku |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275672099 PECOS PAC ID: 2567553894 Enrollment ID: I20150415002362 |
| Provider Name | Timothy Ryan Owens |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1962645382 PECOS PAC ID: 5799006045 Enrollment ID: I20150611002051 |
| Provider Name | Bethanie L Barth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235525064 PECOS PAC ID: 2062723026 Enrollment ID: I20150617000447 |
| Provider Name | Philip M. Oconnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518930841 PECOS PAC ID: 2961715958 Enrollment ID: I20150720003190 |
| Provider Name | John F Wiles |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659639847 PECOS PAC ID: 4688980378 Enrollment ID: I20150825005855 |
| Provider Name | Ma Ley C Kelly |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487917159 PECOS PAC ID: 2365683026 Enrollment ID: I20150831001885 |
| Provider Name | Jay William Floyd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861460313 PECOS PAC ID: 1850491671 Enrollment ID: I20150902000171 |
| Provider Name | Pauline L Jacinto |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1003131988 PECOS PAC ID: 6507055605 Enrollment ID: I20150916001032 |
| Provider Name | Danielle Shelton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326309121 PECOS PAC ID: 2163645532 Enrollment ID: I20150916002190 |
| Provider Name | Holly D Kinsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578947800 PECOS PAC ID: 4789991977 Enrollment ID: I20150921002334 |
| Provider Name | Mary A Hendrickson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700851284 PECOS PAC ID: 6204800667 Enrollment ID: I20150923003132 |
| Provider Name | Melissa A Wood-katz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023040581 PECOS PAC ID: 1153351358 Enrollment ID: I20151013000540 |
| Provider Name | Sruti Pradhan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285870717 PECOS PAC ID: 2163691916 Enrollment ID: I20151109001329 |
| Provider Name | Jennifer E Neely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174990501 PECOS PAC ID: 8729388442 Enrollment ID: I20151202002911 |
| Provider Name | Teresa Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093180630 PECOS PAC ID: 0941503825 Enrollment ID: I20160127000979 |
| Provider Name | Steven Joseph Oberle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043615040 PECOS PAC ID: 3971825910 Enrollment ID: I20160310000462 |
| Provider Name | Amanda Rebecca Mcnulty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851710685 PECOS PAC ID: 4587954656 Enrollment ID: I20160601001815 |
| Provider Name | Lindsey Hodges Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033573530 PECOS PAC ID: 8426341462 Enrollment ID: I20160727002955 |
| Provider Name | Rafael Alba Yunen |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497901987 PECOS PAC ID: 0345536520 Enrollment ID: I20160914002553 |
| Provider Name | Rebecca Smith Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568765774 PECOS PAC ID: 5991984429 Enrollment ID: I20161010000834 |
| Provider Name | Kayota Tolbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215483441 PECOS PAC ID: 0345528089 Enrollment ID: I20161031001442 |
| Provider Name | Patricia A Heinrich |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1659620631 PECOS PAC ID: 3870871585 Enrollment ID: I20161101001188 |
| Provider Name | Julie B. Small |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124576616 PECOS PAC ID: 5597047472 Enrollment ID: I20170130001422 |
| Provider Name | Jacqueline Sahrphillips |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1457501645 PECOS PAC ID: 3971885872 Enrollment ID: I20170130002205 |
| Provider Name | Kimberly Stoughton Doherty |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154326932 PECOS PAC ID: 8325075070 Enrollment ID: I20170131002349 |
| Provider Name | Dustin K Davis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518399096 PECOS PAC ID: 8325353337 Enrollment ID: I20170223000793 |
| Provider Name | Maximo R Beras Jovine |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225422405 PECOS PAC ID: 8426325846 Enrollment ID: I20170606001080 |
| Provider Name | Nicole Alba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235663550 PECOS PAC ID: 7810264249 Enrollment ID: I20170606001409 |
| Provider Name | Kristin Orendorf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366987844 PECOS PAC ID: 4688943277 Enrollment ID: I20170713002254 |
| Provider Name | Antonio A Graham |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1619255148 PECOS PAC ID: 2769625334 Enrollment ID: I20171004000287 |
| Provider Name | James A Hula |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164733390 PECOS PAC ID: 8820231558 Enrollment ID: I20171020002275 |
| Provider Name | Natalia V Chaar-tirado |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1578818506 PECOS PAC ID: 2668762378 Enrollment ID: I20171027001170 |
| Provider Name | Nauman A Siddiqi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427187020 PECOS PAC ID: 2961466610 Enrollment ID: I20171122002176 |
| Provider Name | Justin Stanley Whitlow |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1780847947 PECOS PAC ID: 9537318522 Enrollment ID: I20171213001772 |
| Provider Name | Hollie Ann Temples |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063939619 PECOS PAC ID: 6002174620 Enrollment ID: I20180102002653 |
| Provider Name | Samuel D Critides |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1902856503 PECOS PAC ID: 9537172622 Enrollment ID: I20180130001222 |
| Provider Name | Rene Nicole Fisler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700399060 PECOS PAC ID: 1658631890 Enrollment ID: I20180207001602 |
| Provider Name | Jonathan Andrew Egly |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063623700 PECOS PAC ID: 7416128517 Enrollment ID: I20180328002351 |
| Provider Name | Stephanie Nicole Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124528237 PECOS PAC ID: 8325396369 Enrollment ID: I20180807002642 |
| Provider Name | Nakia J. Wilson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104265909 PECOS PAC ID: 8022331792 Enrollment ID: I20180810000586 |
| Provider Name | Evan Hamilton Fountain |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1588046320 PECOS PAC ID: 5698065084 Enrollment ID: I20180820003734 |
| Provider Name | Christopher D. Chambers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508361841 PECOS PAC ID: 6608126461 Enrollment ID: I20180829002406 |
| Provider Name | Ricardo Mauro Perez Rivera |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821474099 PECOS PAC ID: 7214287911 Enrollment ID: I20180829004614 |
| Provider Name | Tracey R.h. Price |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558779348 PECOS PAC ID: 8426355017 Enrollment ID: I20180901000145 |
| Provider Name | Paul E Sarmiento Sarmiento |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437535614 PECOS PAC ID: 5890045900 Enrollment ID: I20180911003775 |
| Provider Name | Rachel Raney Weaver-hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174039481 PECOS PAC ID: 1951212760 Enrollment ID: I20181008001641 |
| Provider Name | Sarah Renee Mobbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811401854 PECOS PAC ID: 3476805078 Enrollment ID: I20181009003678 |
| Provider Name | Viagnehy Fernandez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124402722 PECOS PAC ID: 3476805763 Enrollment ID: I20181015003507 |
| Provider Name | Jake J Porter |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235492737 PECOS PAC ID: 6103053699 Enrollment ID: I20181023000748 |
| Provider Name | Justin Matthew Whitley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134396153 PECOS PAC ID: 7416170808 Enrollment ID: I20181024000585 |
| Provider Name | Michael C Yonz |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457610917 PECOS PAC ID: 0042538456 Enrollment ID: I20181103000011 |
| Provider Name | Freddy Guevara |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033599931 PECOS PAC ID: 9830488063 Enrollment ID: I20181106001778 |
| Provider Name | Sarah T Blackstock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598249211 PECOS PAC ID: 6002150190 Enrollment ID: I20181129003172 |
| Provider Name | Fred Wayne Frankenberg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669436911 PECOS PAC ID: 1557388899 Enrollment ID: I20190122003543 |
| Provider Name | Ryan Monti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629496880 PECOS PAC ID: 7214201037 Enrollment ID: I20190128002275 |
| Provider Name | Norka Perez Romero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427407022 PECOS PAC ID: 7214219260 Enrollment ID: I20190129002752 |
| Provider Name | Elizabeth A Reece |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255391165 PECOS PAC ID: 8224924972 Enrollment ID: I20190422001647 |
| Provider Name | Edward Odell Reece |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275593188 PECOS PAC ID: 4880593029 Enrollment ID: I20190601000045 |
| Provider Name | Spiro S Mavromates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790148260 PECOS PAC ID: 9436444577 Enrollment ID: I20190806001230 |
| Provider Name | Jordan J. Ahnert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124500939 PECOS PAC ID: 4385987072 Enrollment ID: I20191018001869 |
| Provider Name | Lindsey E Sweat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457733842 PECOS PAC ID: 7113215138 Enrollment ID: I20191104001911 |
| Provider Name | Susana Urgiles |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306298575 PECOS PAC ID: 5597198754 Enrollment ID: I20191203000898 |
| Provider Name | Benjamin Bograd |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316174873 PECOS PAC ID: 1951692516 Enrollment ID: I20200313000842 |
| Provider Name | Elise Jeanne Meeks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922668045 PECOS PAC ID: 4385073428 Enrollment ID: I20200410001325 |
| Provider Name | Kristy Chesser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982235370 PECOS PAC ID: 3678904430 Enrollment ID: I20200511002279 |
| Provider Name | Danielle Mankin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770831588 PECOS PAC ID: 3072863067 Enrollment ID: I20200607000020 |
| Provider Name | Bradley Newton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740639327 PECOS PAC ID: 1951723147 Enrollment ID: I20200616002789 |
| Provider Name | Charity Christine Boree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366098048 PECOS PAC ID: 9537581186 Enrollment ID: I20200626002309 |
| Provider Name | Jelisa Carroll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396271292 PECOS PAC ID: 9537583869 Enrollment ID: I20200721000427 |
| Provider Name | Elena Bryant |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356874598 PECOS PAC ID: 1153608930 Enrollment ID: I20201028001595 |
| Provider Name | Steven Austin Roth |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942386727 PECOS PAC ID: 6103850540 Enrollment ID: I20210120002029 |
| Provider Name | Aileen Cangiano-heath |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609074616 PECOS PAC ID: 9234544735 Enrollment ID: I20210216000446 |
| Provider Name | Justine Nesset |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669067377 PECOS PAC ID: 7911313226 Enrollment ID: I20210311001883 |
| Provider Name | Nicholas Mavromates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376048660 PECOS PAC ID: 6305198276 Enrollment ID: I20210722000006 |
| Provider Name | Andrew Craig Mcgregor |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1952334930 PECOS PAC ID: 9436195021 Enrollment ID: I20210723000218 |
| Provider Name | Ashlie Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871107029 PECOS PAC ID: 5496159972 Enrollment ID: I20210805000655 |
| Provider Name | Ciel Harris |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083097869 PECOS PAC ID: 4284940065 Enrollment ID: I20210813001276 |
| Provider Name | Craig Novack |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285121764 PECOS PAC ID: 0042615304 Enrollment ID: I20210825000118 |
| Provider Name | Gregory Kelley |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1891180113 PECOS PAC ID: 1355671157 Enrollment ID: I20211018000878 |
| Provider Name | Erica Lynn Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548846793 PECOS PAC ID: 4284025511 Enrollment ID: I20211222000007 |
| Provider Name | Chelsea Hurd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538812714 PECOS PAC ID: 1951795145 Enrollment ID: I20220304000533 |
| Provider Name | Abhishek Bhurwal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184011991 PECOS PAC ID: 1052706561 Enrollment ID: I20220321000666 |
| Provider Name | Nicole Eller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679912562 PECOS PAC ID: 3072808666 Enrollment ID: I20220620000781 |
| Provider Name | Jason Bowman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396278065 PECOS PAC ID: 3577820687 Enrollment ID: I20220621002209 |
| Provider Name | Trace Christopher Deighan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134658420 PECOS PAC ID: 8426323627 Enrollment ID: I20220621002461 |
| Provider Name | Diana Elizabeth Peterman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265960306 PECOS PAC ID: 2062783855 Enrollment ID: I20220622000657 |
| Provider Name | Marianne Davignon Somma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902530462 PECOS PAC ID: 2860874542 Enrollment ID: I20220727002008 |
| Provider Name | Philip Villiotte |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1881643443 PECOS PAC ID: 1153354253 Enrollment ID: I20220912001409 |
| Provider Name | Shanna Michele Rompel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629333190 PECOS PAC ID: 4183916174 Enrollment ID: I20221122003708 |
| Provider Name | Kimberly Marie West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669184420 PECOS PAC ID: 2961874433 Enrollment ID: I20230209000897 |
| Provider Name | Benjamin Sandifer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609432699 PECOS PAC ID: 5092040642 Enrollment ID: I20230420003125 |
| Provider Name | Eric Thomas |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447741178 PECOS PAC ID: 6204171127 Enrollment ID: I20230616001726 |
| Provider Name | Hansley Bobo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689202517 PECOS PAC ID: 3173983384 Enrollment ID: I20230720000224 |
| Provider Name | Affiong Nsunwara |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922310457 PECOS PAC ID: 9436386810 Enrollment ID: I20230731000339 |
| Provider Name | Catherine Gurley Clever |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134820855 PECOS PAC ID: 0446604508 Enrollment ID: I20230925001016 |
| Provider Name | Juan Sebastian Arana |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952863649 PECOS PAC ID: 8325493984 Enrollment ID: I20231017002387 |
| Provider Name | Lorieann Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164405676 PECOS PAC ID: 7315393626 Enrollment ID: I20231023003073 |
| Provider Name | Roxanne Mody |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760861256 PECOS PAC ID: 5092021469 Enrollment ID: I20240104002504 |
| Provider Name | Kimberly Tillman Faulk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467053629 PECOS PAC ID: 2567806136 Enrollment ID: I20240222001311 |
| Provider Name | Jenny Mcfaddin Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457116626 PECOS PAC ID: 1557707494 Enrollment ID: I20240313002823 |
Marshes Medical Diagnostic Clinic, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2705 Wildwood Dr, Brunswick, GA 31520 Phone: 912-264-6133 Fax: 912-267-1415 | |
Coastal Community Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 Coastal Village Dr, Brunswick, GA 31520 Phone: 912-554-8510 | |
Oceanhorse Health And Wellness Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1800 Albany St, Brunswick, GA 31520 Phone: 912-571-7497 | |
Glynn Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3025 Shrine Rd, Suite 290, Brunswick, GA 31520 Phone: 912-267-1026 Fax: 912-265-5415 | |
Coastal Community Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2747 4th St, Brunswick, GA 31520 Phone: 912-289-2617 | |
Peds 'r Us, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1606 Norwich St, Brunswick, GA 31520 Phone: 913-262-1039 Fax: 912-275-8320 | |
Allen & Allen Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1623 Reynolds St, Brunswick, GA 31520 Phone: 912-267-1389 |