| Shellman Medical Llc | |
|
67 W Railroad St Shellman GA 39886-3100 | |
| (229) 883-1314 | |
| Not Available |
| Full Name | Shellman Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 67 W Railroad St, Shellman, Georgia |
| Authorized Official Name and Position | Jeremy A Sapp (CEO) |
| Authorized Official Contact | 2298831314 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shellman Medical Llc Po Box 207 Shellman GA 39886-0207 Ph: () - | Shellman Medical Llc 67 W Railroad St Shellman GA 39886-3100 Ph: (229) 883-1314 |
| NPI Number | 1992548994 |
|---|---|
| Provider Enumeration Date | 06/17/2024 |
| Last Update Date | 06/17/2024 |
| Medicare PECOS PAC ID | 2062945330 |
|---|---|
| Medicare Enrollment ID | O20241024002252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992548994 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Wael Azer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841588241 PECOS PAC ID: 5991017840 Enrollment ID: I20150706002543 |
| Provider Name | Jessica Faust |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942658125 PECOS PAC ID: 5698068807 Enrollment ID: I20160726001813 |
| Provider Name | Gail Ricker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245680487 PECOS PAC ID: 4183905664 Enrollment ID: I20161220002357 |
Hospital Authority Of Randolph County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 West Railroad Street, Shellman, GA 39886 Phone: 229-679-5579 Fax: 229-679-5584 | |
Kjh Medical Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 67 W Railroad St, Shellman, GA 39886 Phone: 229-679-2100 Fax: 229-679-2010 |