| Pai Participant 11 Pc | |
|
415 Airport Rd Griffin GA 30224-4834 | |
| (770) 227-8636 | |
| Not Available |
| Full Name | Pai Participant 11 Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 415 Airport Rd, Griffin, Georgia |
| Authorized Official Name and Position | Erin N Laird (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4104588713 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pai Participant 11 Pc Po Box 639676 Cincinnati OH 45263-9676 Ph: (859) 291-4800 | Pai Participant 11 Pc 415 Airport Rd Griffin GA 30224-4834 Ph: (770) 227-8636 |
| NPI Number | 1144887720 |
|---|---|
| Provider Enumeration Date | 05/20/2019 |
| Last Update Date | 08/10/2020 |
| Medicare PECOS PAC ID | 9638405897 |
|---|---|
| Medicare Enrollment ID | O20190725000706 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144887720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Kirpich Joseph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750373023 PECOS PAC ID: 1456304286 Enrollment ID: I20050223000158 |
| Provider Name | Zia Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427122092 PECOS PAC ID: 2668436684 Enrollment ID: I20100825000476 |
| Provider Name | Charles A Bergstrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104886662 PECOS PAC ID: 0244429876 Enrollment ID: I20110112000493 |
| Provider Name | Joy Blumberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437675394 PECOS PAC ID: 7618243221 Enrollment ID: I20171026002533 |
| Provider Name | Camelia L Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831621580 PECOS PAC ID: 4082960638 Enrollment ID: I20180711003843 |
| Provider Name | Myrlande Cayo Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992293997 PECOS PAC ID: 8224380076 Enrollment ID: I20181006000162 |
| Provider Name | Julienne K Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639657620 PECOS PAC ID: 4880946573 Enrollment ID: I20181008001934 |
| Provider Name | Weks Wekongho Anyu-chita |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568947869 PECOS PAC ID: 2860734977 Enrollment ID: I20190419000515 |
| Provider Name | Laura P Slack |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497051767 PECOS PAC ID: 0244401727 Enrollment ID: I20190723001571 |
| Provider Name | Yvanne Jean-obei |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417503889 PECOS PAC ID: 0547693541 Enrollment ID: I20191205000985 |
| Provider Name | Monique Jennifer Stage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174048474 PECOS PAC ID: 5991134389 Enrollment ID: I20200406003379 |
| Provider Name | Syeda Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366639221 PECOS PAC ID: 6103915756 Enrollment ID: I20200902001554 |
| Provider Name | Marie Jose Antoine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922692169 PECOS PAC ID: 8426448168 Enrollment ID: I20211211000042 |
| Provider Name | Roselande Emmanuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336694595 PECOS PAC ID: 1951791524 Enrollment ID: I20211214002104 |
| Provider Name | Patricia Natalie Dillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114685773 PECOS PAC ID: 3173977725 Enrollment ID: I20230929002702 |
| Provider Name | Appoline Matanda Meli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699455964 PECOS PAC ID: 0042666489 Enrollment ID: I20231021000231 |
Mcintosh Trail Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 747 S Hill St, Griffin, GA 30224 Phone: 770-228-5407 Fax: 770-227-1430 | |
Southside Medical Center - Spalding County Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 409 W Solomon St, Griffin, GA 30223 Phone: 678-688-8700 | |
Careconnect Convenient Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1424 N Expressway Ste 121-123, Griffin, GA 30223 Phone: 678-688-2820 Fax: 770-467-9868 | |
Grace Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 230 W College St, B, Griffin, GA 30224 Phone: 678-688-1155 Fax: 678-688-5071 | |
Griffin Family Medicine, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Pecan Point, Suite A, Griffin, GA 30223 Phone: 770-467-8811 | |
Spalding Surgical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 655 Will St, Griffin, GA 30224 Phone: 770-467-6314 Fax: 770-467-6124 |