| Restor Metabolix of Appling | |
|
73 Sw Park Ave Ste C Baxley GA 31513-0485 | |
| (912) 705-4574 | |
| (912) 310-2383 |
| Full Name | Restor Metabolix of Appling |
|---|---|
| Speciality | Clinic/Center |
| Location | 73 Sw Park Ave Ste C, Baxley, Georgia |
| Authorized Official Name and Position | Randall Crawford (OWNER) |
| Authorized Official Contact | 9123392342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restor Metabolix of Appling 73 Sw Park Ave Ste C Baxley GA 31513-0485 Ph: (912) 310-2383 | Restor Metabolix of Appling 73 Sw Park Ave Ste C Baxley GA 31513-0485 Ph: (912) 705-4574 |
| NPI Number | 1780347070 |
|---|---|
| Provider Enumeration Date | 10/14/2021 |
| Last Update Date | 03/27/2023 |
| Certification Date | 10/14/2021 |
| Medicare PECOS PAC ID | 1254729650 |
|---|---|
| Medicare Enrollment ID | O20211103001416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780347070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
| Provider Name | Errol G Graham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821081860 PECOS PAC ID: 0941214019 Enrollment ID: I20060127000167 |
| Provider Name | Michael G Moss |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851554935 PECOS PAC ID: 5092986679 Enrollment ID: I20110913000366 |
| Provider Name | Cynthia Kaye Holton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912252792 PECOS PAC ID: 0547426025 Enrollment ID: I20120727000460 |
| Provider Name | Randall Crawford Jr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740678739 PECOS PAC ID: 6901124858 Enrollment ID: I20150406001498 |
| Provider Name | Rachel Lee Peterson Moss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811302029 PECOS PAC ID: 2365756558 Enrollment ID: I20150731016176 |
| Provider Name | Stephanie Lyne Chadwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376135798 PECOS PAC ID: 0345657300 Enrollment ID: I20210323001515 |
| Provider Name | Paige Tomberlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184337982 PECOS PAC ID: 1759742653 Enrollment ID: I20230725001420 |
Appling Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 105 E Tollison St Ste B, Baxley, GA 31513 Phone: 912-367-0102 Fax: 912-367-9966 |
Telehealth Resources, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 77 North Main Street, Suite B, Baxley, GA 31513 Phone: 912-208-3824 Fax: 912-705-9111 |
Wayne Family Practice Associates, P.C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 118 Azalea Rd Ste 1, Baxley, GA 31513 Phone: 912-294-0380 Fax: 912-427-0591 |
Baxley Medical Clinic, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 331 S Main St, Baxley, GA 31513 Phone: 912-367-9112 Fax: 912-367-6233 |
South Georgia Medical Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 105 E Tollison St, Baxley, GA 31513 Phone: 912-367-4122 Fax: 912-367-4136 |
Family Medicine of Baxley Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 408 S Main St, Baxley, GA 31513 Phone: 912-705-1227 Fax: 912-705-0673 |