MICHAEL J PALKO III (NPI# 1093797144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093797144 |
| Entity Type | Individual |
| Full Name | MICHAEL J PALKO III |
| Credential | MD |
| Practice Address |
510 E Oglethorpe Hwy Hinesville GA 31313 |
| Mailing Address |
2400 Bellevue Rd Suite 21-a Dublin GA 31021-2885 |
| Practice Telephone | 9123697546 |
| Practice Fax Number | 4783280438 |
| Mailing Telephone | 4782757202 |
| Mailing Fax Number | 4782748418 |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2015-04-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZD0900X |
Pathology Specialization: Dermatopathology |
049863 | GA | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
049863 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | RAILROAD MEDICARE | P00176683 | 01 |
| GA | RAILROAD MEDICARE | DC4061 | 01 |
| GA | 000977171C | 05 |
| Street Address |
510 E OGLETHORPE HWY |
| City | HINESVILLE |
| State | GA |
| Zip Code | 31313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093971103 | Christi G Gibson | Physician Assistant | 510 E Oglethorpe Hwy, Hinesville, GA 31313-2825 | 2008-07-29 |
| 1245328913 | Georgia Dermatopathology | Dermatology | 510 E Oglethorpe Hwy, Hinesville, GA 31313 | 2006-10-10 |
| 1740290667 | Richard Peele James Jr. | Dermatology | 510 E Oglethorpe Hwy, Hinesville, GA 31313-2825 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447877469 | Brennan Roger Milbury | Naturopath | 4876 Ga 196 W, Hinesville, GA 31313 | 2020-06-26 |
| 1558982660 | Hinesville Day Spa LLC | Massage Therapist | 951 E G Miles Pkwy, Suite B, Hinesville, GA 31313 | 2020-04-29 |
| 1104459932 | Johnny Roger Terry | Counselor | 115 W Oglethorpe Hwy, Hinesville, GA 31313 | 2020-02-20 |
| 1043875594 | Liberty Regional Medical Center | Pharmacy | 462 Elma G. Miles Parkway, Hinesville, GA 31313 | 2019-05-09 |
| 1730646811 | Jennifer Lee Reffeor | Nurse Practitioner | 109 W Oglethorpe Highway, Hinesville, GA 31313 | 2019-02-26 |
| 1760907968 | Kenya Dominic | Specialist | 445 E.g. Miles Parkway Ste 207, Hinesville, GA 31313 | 2017-08-08 |
| 1902358393 | Tricia Amelung | Nurse Practitioner | 512 South Main St., Suite 1a, Hinesville, GA 31313 | 2016-11-01 |
| 1881065449 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 801-a East General Stewart Way, Hinesville, GA 31313 | 2015-10-08 |
| 1245614916 | Tracey Bazemore | Counselor | 318 S. Wellborn Street, Suite C, Hinesville, GA 31313 | 2015-07-13 |
| 1831592021 | Jennifer Grisnik | Behavioral Analyst | 306 N. Main St., Suite 1a1, Hinesville, GA 31313 | 2014-10-01 |
| Find all providers in zip 31313 | ||||
| Taxonomy Code | 207ZD0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Dermatopathology |
| A dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source added] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. A subspecialty certificate was first issued by the ABMS in 1974. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871630350 | Seth Ian Rosenthal | Pathology | 1901 Phoenix Blvd Ste 210, Atlanta, GA 30349-5062 | 2007-01-31 |
| 1780623785 | Jessie Lee | Pathology | 175 White St Nw, Suite 370, Marietta, GA 30060-1053 | 2006-06-05 |
| 1295798320 | Wayne L Bakotic | Pathology | 114 Mimosa Dr, Suite C, Thomasville, GA 31792-6677 | 2006-04-10 |
| 1134193774 | Drazen M Jukic | Pathology | 5400 Sutlive St, Suite 3, Savannah, GA 31405-4721 | 2006-02-13 |
| 1639158389 | Scott M Acker | Pathology | 6240 Shiloh Rd Ste B, Alpharetta, GA 30005-8347 | 2006-01-11 |
| 1295710754 | Bradley W. Bakotic | Pathology | 2001 Westside Parkway, Suite 290, Alpharetta, GA 30004-8514 | 2005-12-07 |
| 1053392191 | Ling Chen | Pathology | 1951 Clairmont Rd, Decatur, GA 30033-3415 | 2005-11-07 |
| 1649270885 | Jordan H. Berne | Pathology | 6095 Barfield Rd Ne, Suite 200, Atlanta, GA 30328-4408 | 2005-07-29 |
| 1588667380 | Christopher J Kligora | Pathology | 311 W 8th St Ne, Rome, GA 30165-2723 | 2005-05-24 |
| 1912900697 | Steve M Covington IIi | Pathology | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2005-05-24 |
| Find all providers with the same taxonomy | ||||
| City | HINESVILLE |
| Zip Code | 31313 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.