| Sgmc Physician Network Inc | |
|
2501 N Patterson St Valdosta GA 31602-1735 | |
| (229) 433-1997 | |
| (229) 433-1998 |
| Full Name | Sgmc Physician Network Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2501 N Patterson St, Valdosta, Georgia |
| Authorized Official Name and Position | Julie Hodges (CONTROLLER) |
| Authorized Official Contact | 2292594140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sgmc Physician Network Inc Po Box 9 Valdosta GA 31603-0009 Ph: (229) 245-6232 | Sgmc Physician Network Inc 2501 N Patterson St Valdosta GA 31602-1735 Ph: (229) 433-1997 |
| NPI Number | 1417597170 |
|---|---|
| Provider Enumeration Date | 01/10/2020 |
| Last Update Date | 07/28/2022 |
| Certification Date | 07/18/2022 |
| Medicare PECOS PAC ID | 4082036843 |
|---|---|
| Medicare Enrollment ID | O20201015000629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417597170 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| 261QU0200X | Clinic/center - Urgent Care | () | Secondary |
| Provider Name | James C. Eutzler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801887161 PECOS PAC ID: 9931192986 Enrollment ID: I20040406000253 |
| Provider Name | Nitin R Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770511156 PECOS PAC ID: 2466443296 Enrollment ID: I20040520001072 |
| Provider Name | William N Oduro |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720177488 PECOS PAC ID: 5294716007 Enrollment ID: I20040527000559 |
| Provider Name | Leonard F Howard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841227923 PECOS PAC ID: 0244212207 Enrollment ID: I20040603000361 |
| Provider Name | Joe H Johnson |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1326082033 PECOS PAC ID: 8022919505 Enrollment ID: I20040622000832 |
| Provider Name | Robert D Collins |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1447250220 PECOS PAC ID: 6901882182 Enrollment ID: I20040628001126 |
| Provider Name | Alberto E Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518047547 PECOS PAC ID: 1557331089 Enrollment ID: I20040730000342 |
| Provider Name | Vera C Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154401107 PECOS PAC ID: 6204815160 Enrollment ID: I20040730000376 |
| Provider Name | Sara N Yarbrough |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437235199 PECOS PAC ID: 2466423314 Enrollment ID: I20040804000262 |
| Provider Name | Pamela H Temples |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740366442 PECOS PAC ID: 8527039445 Enrollment ID: I20040804000735 |
| Provider Name | Richard W.A. Rickman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609809300 PECOS PAC ID: 8921074667 Enrollment ID: I20040907000110 |
| Provider Name | Charles P Murrah |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1942253430 PECOS PAC ID: 5294635470 Enrollment ID: I20040916000375 |
| Provider Name | Thomas W Hobby |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497749733 PECOS PAC ID: 5092763318 Enrollment ID: I20050104000332 |
| Provider Name | Alford T Brady |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467449272 PECOS PAC ID: 8628026960 Enrollment ID: I20050104000504 |
| Provider Name | Kimberly S Snow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730308883 PECOS PAC ID: 9830147297 Enrollment ID: I20050112000376 |
| Provider Name | Kathleen S Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104819689 PECOS PAC ID: 1658322599 Enrollment ID: I20050208000579 |
| Provider Name | Bennett P Hogan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205891397 PECOS PAC ID: 2769434794 Enrollment ID: I20050217000468 |
| Provider Name | Dennis R Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821031329 PECOS PAC ID: 8729032685 Enrollment ID: I20050303000847 |
| Provider Name | James L Foster |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1235172230 PECOS PAC ID: 2567404353 Enrollment ID: I20050523000442 |
| Provider Name | Nathaniel David Lewis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740255389 PECOS PAC ID: 7719914118 Enrollment ID: I20050718000516 |
| Provider Name | Charles Bruce Moomey |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1689671364 PECOS PAC ID: 4981622487 Enrollment ID: I20051109000841 |
| Provider Name | William Nash |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235172628 PECOS PAC ID: 6204729619 Enrollment ID: I20060720000227 |
| Provider Name | Wendy Vandemark |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386698231 PECOS PAC ID: 2264491554 Enrollment ID: I20060802000052 |
| Provider Name | Tobi a Okafo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255383246 PECOS PAC ID: 3870596976 Enrollment ID: I20060810000113 |
| Provider Name | Shawn D Vandemark |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1336188176 PECOS PAC ID: 0244233989 Enrollment ID: I20060817000485 |
| Provider Name | Nicolas Psomiadis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720059637 PECOS PAC ID: 6800890278 Enrollment ID: I20060828000371 |
| Provider Name | Mahmood S Eisa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184606824 PECOS PAC ID: 1456375161 Enrollment ID: I20061211000217 |
| Provider Name | Jerthitia S Taylor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467468561 PECOS PAC ID: 8022010339 Enrollment ID: I20070215000066 |
| Provider Name | Mark a Globerman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235299249 PECOS PAC ID: 9638274251 Enrollment ID: I20070410000362 |
| Provider Name | Joel E Higgins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336189414 PECOS PAC ID: 0244335008 Enrollment ID: I20070424000203 |
| Provider Name | Albert I Richardson |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1558469981 PECOS PAC ID: 8022116698 Enrollment ID: I20070605000360 |
| Provider Name | Hernando Moreno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396950994 PECOS PAC ID: 0840390944 Enrollment ID: I20070702000498 |
| Provider Name | Kamil I Hanna |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1881632099 PECOS PAC ID: 0749266831 Enrollment ID: I20070725000256 |
| Provider Name | Brian C Griner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366470650 PECOS PAC ID: 2163514175 Enrollment ID: I20070906000041 |
| Provider Name | Keisa G Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629286745 PECOS PAC ID: 2668553868 Enrollment ID: I20080114000596 |
| Provider Name | Carlo Lee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083619779 PECOS PAC ID: 1355424110 Enrollment ID: I20080218000025 |
| Provider Name | Phillip E Hadley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215098454 PECOS PAC ID: 4688750425 Enrollment ID: I20080319000558 |
| Provider Name | David W Retterbush |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396910337 PECOS PAC ID: 1456430537 Enrollment ID: I20080430000496 |
| Provider Name | Bradley G Ridge |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902981996 PECOS PAC ID: 1456429455 Enrollment ID: I20081003000467 |
| Provider Name | Francis Kwarteng |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851551923 PECOS PAC ID: 1052470705 Enrollment ID: I20081110000521 |
| Provider Name | Paul Murray |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730183542 PECOS PAC ID: 1355400805 Enrollment ID: I20081112000684 |
| Provider Name | Timothy P Villegas |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942393210 PECOS PAC ID: 6406906262 Enrollment ID: I20090617000076 |
| Provider Name | Wendy P Copeland |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982847174 PECOS PAC ID: 5496807448 Enrollment ID: I20090722000328 |
| Provider Name | Stephen T Zeigler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649270554 PECOS PAC ID: 2466595467 Enrollment ID: I20100129000388 |
| Provider Name | Vanessa Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861503757 PECOS PAC ID: 4880729672 Enrollment ID: I20100318000464 |
| Provider Name | Steven B Dawson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578605259 PECOS PAC ID: 9537178348 Enrollment ID: I20100514000836 |
| Provider Name | Asa A. Peek |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336127802 PECOS PAC ID: 1951432988 Enrollment ID: I20100708000265 |
| Provider Name | William Harvey Miller |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326011057 PECOS PAC ID: 2961546551 Enrollment ID: I20100712000253 |
| Provider Name | Dallas M Miller |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184697815 PECOS PAC ID: 1052455649 Enrollment ID: I20100715000010 |
| Provider Name | John Kendrick |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164426136 PECOS PAC ID: 0345132197 Enrollment ID: I20100826000683 |
| Provider Name | Paul a Smurda |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053416511 PECOS PAC ID: 2365567542 Enrollment ID: I20100910000724 |
| Provider Name | Jonathan L Underwood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265612972 PECOS PAC ID: 6406040005 Enrollment ID: I20101027001264 |
| Provider Name | Erna a Waxman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487637617 PECOS PAC ID: 6901091867 Enrollment ID: I20101117000856 |
| Provider Name | Kurt Martinuzzi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770504128 PECOS PAC ID: 3476653775 Enrollment ID: I20101129000716 |
| Provider Name | Annette S Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629129390 PECOS PAC ID: 5092902437 Enrollment ID: I20101210000061 |
| Provider Name | Dorraine B Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841504156 PECOS PAC ID: 1658569173 Enrollment ID: I20101228000981 |
| Provider Name | Jesse B Eason |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659666063 PECOS PAC ID: 1658549977 Enrollment ID: I20110712000422 |
| Provider Name | Jarod F Bailey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649432733 PECOS PAC ID: 4688842198 Enrollment ID: I20110727000221 |
| Provider Name | Kevin Keith |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033378963 PECOS PAC ID: 5092989228 Enrollment ID: I20111123000693 |
| Provider Name | Hernan Nunez Posas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689786055 PECOS PAC ID: 3971653221 Enrollment ID: I20120308000584 |
| Provider Name | Carl Woods |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174550727 PECOS PAC ID: 6103803903 Enrollment ID: I20120322000168 |
| Provider Name | Keith W Munoz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437193927 PECOS PAC ID: 6406824556 Enrollment ID: I20120829000227 |
| Provider Name | Stephen Anthony Nickisch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578596615 PECOS PAC ID: 0042114514 Enrollment ID: I20130702000576 |
| Provider Name | Rita Drake Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346679537 PECOS PAC ID: 0345478814 Enrollment ID: I20140107000631 |
| Provider Name | Stephanie Lynn Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649542143 PECOS PAC ID: 4880822857 Enrollment ID: I20140121000869 |
| Provider Name | Stanley Soles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750790465 PECOS PAC ID: 3779800834 Enrollment ID: I20150330001084 |
| Provider Name | Dakshaben P Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467793000 PECOS PAC ID: 4183936107 Enrollment ID: I20150706001481 |
| Provider Name | David M Hardy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548467939 PECOS PAC ID: 7517105299 Enrollment ID: I20150902000673 |
| Provider Name | Rudolph King |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194797555 PECOS PAC ID: 4688820087 Enrollment ID: I20150929000388 |
| Provider Name | Jennifer L Parrish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952786006 PECOS PAC ID: 2567770019 Enrollment ID: I20151001002731 |
| Provider Name | Mandy Lucas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346531662 PECOS PAC ID: 6800105198 Enrollment ID: I20151028001053 |
| Provider Name | Travis L Bailey |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1164711313 PECOS PAC ID: 9234449497 Enrollment ID: I20151030001637 |
| Provider Name | Anthony Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104186246 PECOS PAC ID: 4880850692 Enrollment ID: I20151102000983 |
| Provider Name | Windy Dawn Giddens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720451982 PECOS PAC ID: 1456651926 Enrollment ID: I20151207000177 |
| Provider Name | Anesha Gray |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831455682 PECOS PAC ID: 8325268501 Enrollment ID: I20160720002317 |
| Provider Name | Jana D Harrod |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477900355 PECOS PAC ID: 3779877121 Enrollment ID: I20160808000638 |
| Provider Name | Randal Jared Sanders |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780983478 PECOS PAC ID: 4789832478 Enrollment ID: I20160809000228 |
| Provider Name | Julene D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083071898 PECOS PAC ID: 6406134238 Enrollment ID: I20161031000790 |
| Provider Name | Thomas J Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639627029 PECOS PAC ID: 1153600473 Enrollment ID: I20161109001301 |
| Provider Name | Michael Edward Kuo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760922264 PECOS PAC ID: 1658648258 Enrollment ID: I20170602001278 |
| Provider Name | Bernard J Wortman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386181238 PECOS PAC ID: 5092084145 Enrollment ID: I20170705000613 |
| Provider Name | Taylor N Fiveash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962922427 PECOS PAC ID: 7618249558 Enrollment ID: I20170828001053 |
| Provider Name | Margaret C Carter-poore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235652421 PECOS PAC ID: 6507139136 Enrollment ID: I20170901002753 |
| Provider Name | Robert J Maydell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851547327 PECOS PAC ID: 0749573665 Enrollment ID: I20170907002925 |
| Provider Name | Vicy Carroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417470162 PECOS PAC ID: 2567737083 Enrollment ID: I20171010002251 |
| Provider Name | Nathan Kelly Roberson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023532280 PECOS PAC ID: 6507122306 Enrollment ID: I20171110002426 |
| Provider Name | Lila L Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932620598 PECOS PAC ID: 5991061400 Enrollment ID: I20171115002335 |
| Provider Name | Laura Guadiana |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1598084386 PECOS PAC ID: 5991920340 Enrollment ID: I20180125002138 |
| Provider Name | Chinmay Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366859233 PECOS PAC ID: 4284994476 Enrollment ID: I20180208000693 |
| Provider Name | Michael E Anigbogu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417277625 PECOS PAC ID: 4082873161 Enrollment ID: I20180530000858 |
| Provider Name | James Richard Davis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033354741 PECOS PAC ID: 0244488930 Enrollment ID: I20180822001729 |
| Provider Name | Ashley Louise Exum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083122709 PECOS PAC ID: 4183974728 Enrollment ID: I20180901000148 |
| Provider Name | Loan L Vu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780909879 PECOS PAC ID: 3870769557 Enrollment ID: I20181004003060 |
| Provider Name | William Eanes Courson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720427388 PECOS PAC ID: 7416251921 Enrollment ID: I20181015001417 |
| Provider Name | Linnea a Mehls |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811315666 PECOS PAC ID: 2567760853 Enrollment ID: I20181128000830 |
| Provider Name | Keegan T Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336615517 PECOS PAC ID: 6103160254 Enrollment ID: I20181130001779 |
| Provider Name | Dilleta a Shackelford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811209208 PECOS PAC ID: 5294070736 Enrollment ID: I20190102002298 |
| Provider Name | Heather Whitney Eldridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811474828 PECOS PAC ID: 4183964216 Enrollment ID: I20190327000934 |
| Provider Name | Robert G Kirtley |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1477780708 PECOS PAC ID: 1153654769 Enrollment ID: I20190613002957 |
| Provider Name | Daniel Sohinki |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1992094106 PECOS PAC ID: 9739484106 Enrollment ID: I20190718001800 |
| Provider Name | Apurav a Panwala |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1154684678 PECOS PAC ID: 7810207974 Enrollment ID: I20190807004159 |
| Provider Name | Brian R Pisula |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477999126 PECOS PAC ID: 3577789387 Enrollment ID: I20190822002932 |
| Provider Name | Nicholas a Taylor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1922565282 PECOS PAC ID: 5193053494 Enrollment ID: I20190824000031 |
| Provider Name | Seth a Courson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952763302 PECOS PAC ID: 0446544928 Enrollment ID: I20190912000497 |
| Provider Name | Michael D Caoile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184286684 PECOS PAC ID: 1153653829 Enrollment ID: I20191029003704 |
| Provider Name | Dhaval P Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104288927 PECOS PAC ID: 1759677883 Enrollment ID: I20200111000003 |
| Provider Name | Bhumiben Kushal Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467004507 PECOS PAC ID: 8628403680 Enrollment ID: I20200121002611 |
| Provider Name | Rachael N. Jefferson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447766738 PECOS PAC ID: 0840626545 Enrollment ID: I20200128001859 |
| Provider Name | James Phillip Smith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376517789 PECOS PAC ID: 2769810522 Enrollment ID: I20200310002503 |
| Provider Name | Robin Dillard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871740324 PECOS PAC ID: 6709813330 Enrollment ID: I20200420000994 |
| Provider Name | Matthew Brown |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1275916827 PECOS PAC ID: 2567709710 Enrollment ID: I20200819003440 |
| Provider Name | Kenneth James Burnsed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730796111 PECOS PAC ID: 9830165844 Enrollment ID: I20201029000948 |
| Provider Name | Daryoosh Derakhshan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1881936631 PECOS PAC ID: 5698068724 Enrollment ID: I20201102001487 |
| Provider Name | Ruth H Duda |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063482230 PECOS PAC ID: 1456680842 Enrollment ID: I20201216002614 |
| Provider Name | Jessica E Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831700947 PECOS PAC ID: 2163835679 Enrollment ID: I20201230000585 |
| Provider Name | Ivan Friant |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952723777 PECOS PAC ID: 9335372093 Enrollment ID: I20210115001511 |
| Provider Name | Shelby Mcneal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265020358 PECOS PAC ID: 1254745409 Enrollment ID: I20210128002391 |
| Provider Name | Harold Howe |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1346500386 PECOS PAC ID: 4082879606 Enrollment ID: I20210217000918 |
| Provider Name | Lauren Melissa Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114512050 PECOS PAC ID: 8123435369 Enrollment ID: I20210406000249 |
| Provider Name | Vijay Bandhakavi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1184887473 PECOS PAC ID: 1951557859 Enrollment ID: I20210803003225 |
| Provider Name | Cheryl Lynn Chadwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952972259 PECOS PAC ID: 4981008802 Enrollment ID: I20210813001342 |
| Provider Name | Ryan Scott Brandt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356845788 PECOS PAC ID: 8527303007 Enrollment ID: I20210830001388 |
| Provider Name | Lucas Seibolt |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588074140 PECOS PAC ID: 6204100563 Enrollment ID: I20210914003144 |
| Provider Name | Rita Medina |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1922419928 PECOS PAC ID: 7911278627 Enrollment ID: I20210915000499 |
| Provider Name | Shahin Etebar |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1194721308 PECOS PAC ID: 1850445123 Enrollment ID: I20210917002061 |
| Provider Name | Austin W Sorchik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598256331 PECOS PAC ID: 7810318839 Enrollment ID: I20210928001895 |
| Provider Name | Hannah Cheek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316573934 PECOS PAC ID: 6608264916 Enrollment ID: I20211019001158 |
| Provider Name | Jennifer L Flake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396400859 PECOS PAC ID: 6204225360 Enrollment ID: I20211110002007 |
| Provider Name | Stacey L Newsome |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497390116 PECOS PAC ID: 3476940727 Enrollment ID: I20220505000244 |
| Provider Name | Jason Boyd Langley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194471060 PECOS PAC ID: 2668859497 Enrollment ID: I20220517003288 |
| Provider Name | Edward Distler |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891180352 PECOS PAC ID: 8224381421 Enrollment ID: I20220707002997 |
| Provider Name | John William Perry |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1306379813 PECOS PAC ID: 7416227731 Enrollment ID: I20220720004034 |
| Provider Name | Suhani J Patel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366175101 PECOS PAC ID: 8325422850 Enrollment ID: I20220901002655 |
| Provider Name | Rebecca Lynn Wilkes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588623540 PECOS PAC ID: 4082671680 Enrollment ID: I20221026000464 |
| Provider Name | Megan Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568198000 PECOS PAC ID: 8921479510 Enrollment ID: I20230118001525 |
| Provider Name | Richard Bias |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518595339 PECOS PAC ID: 0143645325 Enrollment ID: I20230125001505 |
| Provider Name | Madison Hill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811474133 PECOS PAC ID: 0143629311 Enrollment ID: I20230323000981 |
| Provider Name | Carolina Marie Manceaux |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124736319 PECOS PAC ID: 4284009432 Enrollment ID: I20230331001643 |
| Provider Name | Vadley Faugue |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982220281 PECOS PAC ID: 3375901879 Enrollment ID: I20230615000124 |
| Provider Name | Jayme Erin Parker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912528084 PECOS PAC ID: 3779941471 Enrollment ID: I20230627002371 |
| Provider Name | Amrendra K Mandal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1518480250 PECOS PAC ID: 1254675358 Enrollment ID: I20230705000203 |
| Provider Name | Jeff Anucha |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1942652524 PECOS PAC ID: 3072973270 Enrollment ID: I20230719004304 |
| Provider Name | Brittany Michelle Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780357152 PECOS PAC ID: 8325408263 Enrollment ID: I20230724002635 |
| Provider Name | Ene Grace Morgan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821651951 PECOS PAC ID: 9830551779 Enrollment ID: I20230809003335 |
| Provider Name | Reanne Catherine Harris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841829272 PECOS PAC ID: 0648633180 Enrollment ID: I20230830003583 |
| Provider Name | Kimberly Davis Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457036857 PECOS PAC ID: 5991168304 Enrollment ID: I20230901001967 |
| Provider Name | Katelin Cristine Mcleod |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407539620 PECOS PAC ID: 8022464114 Enrollment ID: I20231025003142 |
| Provider Name | Leigh Hendley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437795572 PECOS PAC ID: 7911390133 Enrollment ID: I20231219003738 |
| Provider Name | Matthew Brian Shelnutt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053831818 PECOS PAC ID: 3375812134 Enrollment ID: I20240109002262 |
| Provider Name | Vivek Yadav |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1003331638 PECOS PAC ID: 2365882818 Enrollment ID: I20240430004225 |
| Provider Name | William Thomas Mulligan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023868999 PECOS PAC ID: 8527408699 Enrollment ID: I20240507000497 |
| Provider Name | Shalese Stone Aycock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386331734 PECOS PAC ID: 8729521836 Enrollment ID: I20240618000734 |
| Provider Name | Colby Samuelson Ruiz |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1891258257 PECOS PAC ID: 5294078291 Enrollment ID: I20240712002412 |
| Provider Name | John Losee |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1932138906 PECOS PAC ID: 2365495231 Enrollment ID: I20240717003979 |
| Provider Name | Allison Leigh-smith Rupp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881269835 PECOS PAC ID: 3577953454 Enrollment ID: I20241017002422 |
| Provider Name | Roohi Farooq |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982224622 PECOS PAC ID: 6204252935 Enrollment ID: I20241028000149 |
| Provider Name | Amanda Leigh Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437986486 PECOS PAC ID: 4789119892 Enrollment ID: I20241126004026 |
| Provider Name | Candace Isabel Roman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942085220 PECOS PAC ID: 7012444920 Enrollment ID: I20241217000968 |
| Provider Name | Devan Whittington Lenhart |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275038176 PECOS PAC ID: 2264789270 Enrollment ID: I20241221000019 |
| Provider Name | Margaret Grantham Rodisch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205665866 PECOS PAC ID: 6406383728 Enrollment ID: I20250109000721 |
| Provider Name | Dameka Runise Wilson-vickers |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1033938550 PECOS PAC ID: 4587193313 Enrollment ID: I20250123003123 |
| Provider Name | Rachelle Barthelemy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285173278 PECOS PAC ID: 2163709049 Enrollment ID: I20250203002031 |
| Provider Name | Guilherme Czelusniak De Oliveira |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1841796257 PECOS PAC ID: 8820345911 Enrollment ID: I20250505000564 |
| Provider Name | Rehan Dawood |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184019705 PECOS PAC ID: 5496267080 Enrollment ID: I20250620000025 |
| Provider Name | Latorya Shanvoyius Armour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336949189 PECOS PAC ID: 8022521483 Enrollment ID: I20250630000495 |
| Provider Name | Arleen Ramirez Jimenez |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215415955 PECOS PAC ID: 7214267632 Enrollment ID: I20250718000274 |
| Provider Name | Mohab Wael Noman Hassib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649822768 PECOS PAC ID: 9739696840 Enrollment ID: I20250724001856 |
| Provider Name | Anthony D'abarno |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1871158014 PECOS PAC ID: 7214363761 Enrollment ID: I20250805001288 |
| Provider Name | Alec J. Seaton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114554730 PECOS PAC ID: 1254753718 Enrollment ID: I20250813000001 |
| Provider Name | Victoria Lynn Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780262279 PECOS PAC ID: 6103325246 Enrollment ID: I20250815004116 |
| Provider Name | Myra Jordan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1457657637 PECOS PAC ID: 1850890740 Enrollment ID: I20250818002825 |
| Provider Name | Kassi Laiten Copeland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164306692 PECOS PAC ID: 7517467905 Enrollment ID: I20250820004641 |
| Provider Name | Syed Mehdi Jafri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1649558230 PECOS PAC ID: 9436382108 Enrollment ID: I20250829004615 |
| Provider Name | Robin M Dees |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548205982 PECOS PAC ID: 4981106697 Enrollment ID: I20250903002479 |
| Provider Name | Katherine Powell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972501419 PECOS PAC ID: 9335284462 Enrollment ID: I20250923004071 |
| Provider Name | Kathleen Dawood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104523794 PECOS PAC ID: 3779924287 Enrollment ID: I20251009004615 |
| Provider Name | Jynger Morris Huling |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346411725 PECOS PAC ID: 4284121450 Enrollment ID: I20251013003494 |
| Provider Name | Brandi Kautzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528933983 PECOS PAC ID: 0446748354 Enrollment ID: I20251022004545 |
| Provider Name | Theodore Krum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700811387 PECOS PAC ID: 9537175096 Enrollment ID: I20260211003458 |
| Provider Name | Katlyn Nicole Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083591176 PECOS PAC ID: 6305329491 Enrollment ID: I20260317002419 |
Joseph S Thomas M D Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Connell Rd, Ste T, Valdosta, GA 31602 Phone: 229-242-9565 Fax: 229-242-1725 |
Care Medical Center LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2804 N Oak St, Suite C, Valdosta, GA 31602 Phone: 229-241-8925 Fax: 229-241-7672 |
Griner Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3301 N Oak Street Ext, Valdosta, GA 31605 Phone: 229-242-6061 Fax: 229-242-6151 |
Valdosta Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3300 Greystone Way, Valdosta, GA 31605 Phone: 229-247-7700 |
Sgmc Affiliated Services LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2501 N Patterson St, Valdosta, GA 31602 Phone: 229-433-1000 |
Valdosta Gastroenterology Associates, LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 410 Connell Rd, Valdosta, GA 31602 Phone: 229-244-1570 Fax: 229-247-1084 |