| Mountain Lakes Medical Group | |
|
180 Legacy Point Suite 201 Clayton GA 30525 | |
| (706) 782-3100 | |
| Not Available |
| Full Name | Mountain Lakes Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 180 Legacy Point, Clayton, Georgia |
| Authorized Official Name and Position | Matthew Lemak (CEO) |
| Authorized Official Contact | 2053297501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Lakes Medical Group 162 Legacy Pt Clayton GA 30525-5354 Ph: () - | Mountain Lakes Medical Group 180 Legacy Point Suite 201 Clayton GA 30525 Ph: (706) 782-3100 |
| NPI Number | 1972116630 |
|---|---|
| Provider Enumeration Date | 08/24/2020 |
| Last Update Date | 08/18/2022 |
| Medicare PECOS PAC ID | 4981023983 |
|---|---|
| Medicare Enrollment ID | O20200924001019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972116630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Keith R Jackson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1225016454 PECOS PAC ID: 4183685530 Enrollment ID: I20041020000342 |
| Provider Name | Michael A Hollifield |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831162437 PECOS PAC ID: 3678526175 Enrollment ID: I20050224000548 |
| Provider Name | Mary Draucek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801235817 PECOS PAC ID: 8022259704 Enrollment ID: I20130723000145 |
| Provider Name | Rebecca Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750874707 PECOS PAC ID: 1658629605 Enrollment ID: I20180807003340 |
| Provider Name | Brett A Magner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356736417 PECOS PAC ID: 9032418058 Enrollment ID: I20190809002813 |
| Provider Name | Virginia Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376141101 PECOS PAC ID: 5890102586 Enrollment ID: I20230516003761 |
North Shore Healthcare Associates - Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 331 Ridgecrest Cir, Clayton, GA 30525 Phone: 706-782-0440 | |
Stephens County Hospital Physician Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 189 Bo James St Ste 105, Clayton, GA 30525 Phone: 706-282-4200 | |
Medlink Rabun North Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 773 N Main St, Clayton, GA 30525 Phone: 706-782-5991 | |
Clayton Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 458 N Main St, Clayton, GA 30525 Phone: 706-960-9550 Fax: 706-960-9551 | |
Mountain Laurel Medical Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 156 N Main St, Clayton, GA 30525 Phone: 706-782-0293 Fax: 706-782-0118 | |
Medlink Georgia, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 563 Mountain City Rd, Clayton, GA 30525 Phone: 706-521-3113 | |
Medlink Rabun Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 896 Highway 441 S, Clayton, GA 30525 Phone: 706-782-5991 Fax: 706-782-5111 |