| Rst Medical Group | |
|
4150 Snapfinger Woods Dr 208 Decatur GA 30035-3417 | |
| (404) 826-2827 | |
| (404) 941-8788 |
| Full Name | Rst Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 4150 Snapfinger Woods Dr, Decatur, Georgia |
| Authorized Official Name and Position | Denise Dunn (PRESIDENT) |
| Authorized Official Contact | 4044220027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rst Medical Group 4150 Snapfinger Woods Dr 208 Decatur GA 30035-3417 Ph: (404) 826-2877 | Rst Medical Group 4150 Snapfinger Woods Dr 208 Decatur GA 30035-3417 Ph: (404) 826-2827 |
| NPI Number | 1619242039 |
|---|---|
| Provider Enumeration Date | 03/19/2012 |
| Last Update Date | 09/12/2012 |
| Medicare PECOS PAC ID | 5193973584 |
|---|---|
| Medicare Enrollment ID | O20120910000267 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619242039 | NPI | - | NPPES |
| 00804339D | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | RN200088 (Georgia) | Primary |
| Provider Name | Ahmad K Jingo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467416602 PECOS PAC ID: 7517068414 Enrollment ID: I20070723000248 |
| Provider Name | Marilyn Elaine Whitening |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730448564 PECOS PAC ID: 2365607868 Enrollment ID: I20120709000306 |
| Provider Name | Jay Frederick Morgan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447699152 PECOS PAC ID: 8527380294 Enrollment ID: I20180831002324 |
| Provider Name | Cecilia A Jones-asgill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689131823 PECOS PAC ID: 3274967997 Enrollment ID: I20200103002191 |
| Provider Name | Christina Siewe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952906430 PECOS PAC ID: 3476957309 Enrollment ID: I20210813001693 |
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