| Port Medical Management Inc | |
|
920 S West St Bainbridge GA 39819-4581 | |
| (229) 400-0498 | |
| Not Available |
| Full Name | Port Medical Management Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 920 S West St, Bainbridge, Georgia |
| Authorized Official Name and Position | Jennifer Moore (OFFICE MANAGER) |
| Authorized Official Contact | 2294000498 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Medical Management Inc 922 S West St Bainbridge GA 39819-4581 Ph: (229) 248-8499 | Port Medical Management Inc 920 S West St Bainbridge GA 39819-4581 Ph: (229) 400-0498 |
| NPI Number | 1932731361 |
|---|---|
| Provider Enumeration Date | 02/04/2020 |
| Last Update Date | 02/05/2020 |
| Medicare PECOS PAC ID | 8729418454 |
|---|---|
| Medicare Enrollment ID | O20200421003101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932731361 | NPI | - | NPPES |
| 1013306547 | Other | GA | FAMILY PRACTICE |
| 1174851745 | Other | GA | FAMILY PRACTICE |
| 1972570943 | Other | GA | FAMILY PRACTICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Darrell S Surratt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972570943 PECOS PAC ID: 7214972405 Enrollment ID: I20050628000722 |
| Provider Name | Zacharey A Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851884068 PECOS PAC ID: 2668721416 Enrollment ID: I20180828000878 |
| Provider Name | Kimberely Dawn Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215416516 PECOS PAC ID: 0143605113 Enrollment ID: I20220913000667 |
Hospital Authority Of The City Of Bainbridge And Decatur County Georgi Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 603 Wheat Ave Ste 650, Bainbridge, GA 39819 Phone: 229-243-6900 Fax: 229-243-6919 | |
Primary Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 S Blvd Dr, Bainbridge, GA 39819 Phone: 229-243-8000 Fax: 229-246-7026 | |
Hospital Authority Of The City Of Bainbridge And Decatur County Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1500 E Shotwell St, Bainbridge, GA 39819 Phone: 229-246-3500 Fax: 229-246-8142 | |
Hospital Authority Of The City Of Bainbridge And Decatur County Georgi Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1504 E Evans St, Bainbridge, GA 39819 Phone: 229-246-6600 | |
Aurora Medical Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 832 E Shotwell St, Bainbridge, GA 39819 Phone: 229-234-6146 Fax: 229-207-4127 | |
J. Sydney Cochran,mdpc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1504 E Evans St, Bainbridge, GA 39819 Phone: 229-246-6600 Fax: 229-246-9322 | |
Stephen Wiley Barber Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 322 Bubber Rd, Bainbridge, GA 39817 Phone: 229-220-5232 |