| Primary Care Group Of West Georgia | |
|
100 Professional Pl Suite 204 Carrollton GA 30117-3874 | |
| (770) 834-3351 | |
| (770) 838-1722 |
| Full Name | Primary Care Group Of West Georgia |
|---|---|
| Speciality | Family Medicine |
| Location | 100 Professional Pl, Carrollton, Georgia |
| Authorized Official Name and Position | Trebba Putnam (ADMINISTRATOR) |
| Authorized Official Contact | 7708343351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Group Of West Georgia 100 Professional Pl Suite 204 Carrollton GA 30117-3874 Ph: (770) 834-3351 | Primary Care Group Of West Georgia 100 Professional Pl Suite 204 Carrollton GA 30117-3874 Ph: (770) 834-3351 |
| NPI Number | 1386635852 |
|---|---|
| Provider Enumeration Date | 11/02/2005 |
| Last Update Date | 04/04/2008 |
| Medicare PECOS PAC ID | 6709772197 |
|---|---|
| Medicare Enrollment ID | O20040224000098 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386635852 | NPI | - | NPPES |
| CA9972 | Other | GA | RAIL ROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | (* (Not Available)) | Secondary |
| Provider Name | Hermogenes B Pagsisihan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184615759 PECOS PAC ID: 1052381936 Enrollment ID: I20040728000916 |
| Provider Name | Jeffrey S Reid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639104748 PECOS PAC ID: 0547295768 Enrollment ID: I20050927000830 |
| Provider Name | Lindsey B Roenigk |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1467404871 PECOS PAC ID: 0648280701 Enrollment ID: I20081117000183 |
| Provider Name | Joseph M Jellicorse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932190535 PECOS PAC ID: 7810095296 Enrollment ID: I20100329000032 |
| Provider Name | Lauren Holcombe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487153839 PECOS PAC ID: 0749536449 Enrollment ID: I20180711001712 |
| Provider Name | Jessica C. Kearney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538652987 PECOS PAC ID: 8527390533 Enrollment ID: I20191024000635 |
| Provider Name | Ashley Arrington Skinner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841866225 PECOS PAC ID: 0840694790 Enrollment ID: I20210813002519 |
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The Rouse Foundation, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 158 Newnan Road, Carrollton, GA 30117 Phone: 770-328-5458 | |
Joseph S. Palin, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 E Ward St, Carrollton, GA 30117 Phone: 770-836-1011 Fax: 770-836-1049 | |
Drs Gentry Wellborn & Mcghee Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 624 Dixie Street, Carrollton, GA 30117 Phone: 770-832-9593 Fax: 770-832-0440 | |
West Georgia Internal Medicine Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 706 Dixie St Ste 300, Carrollton, GA 30117 Phone: 770-834-6208 Fax: 770-830-7620 | |
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