DR. ROBERT M PACKER III (NPI# 1417948282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417948282 |
| Entity Type | Individual |
| Full Name | DR. ROBERT M PACKER III |
| Credential | M.D. |
| Practice Address |
711 Knight Ave Waycross GA 31501-1943 |
| Practice Telephone | 9122839423 |
| Practice Fax Number | 9122838204 |
| Mailing Telephone | 9122839423 |
| Mailing Fax Number | 9122838204 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2016-04-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 18716 | GA | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
18716 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000151665C | 05 | |
| GA | MEDICARE NPI | 1417948282 | 01 |
| GA | RAILROAD MEDICARE GROUP ID | CG6045 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366453516 | Robert H Packer | Dermatology | 8550 W 38th Ave, Ste 108, Wheat Ridge, CO 80033 | 2006-08-11 |
| 1770564098 | Robert Charles Packer | Ophthalmology | 1266 E Sherman Blvd, Muskegon, MI 49444-1847 | 2005-11-14 |
| 1679572317 | Robert B Packer | Internal Medicine | 1330 Mercy Dr Nw, Canton, OH 44708 | 2005-07-15 |
| Street Address |
711 KNIGHT AVE |
| City | WAYCROSS |
| State | GA |
| Zip Code | 31501-1943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831456409 | Roxy J Sheffield | Physician Assistant | 711 Knight Ave, Waycross, GA 31501-1943 | 2012-04-19 |
| 1396983227 | Mitzi Braddock Tyre | Registered Nurse | 711 Knight Ave, Waycross, GA 31501-1943 | 2009-01-30 |
| 1144420530 | Internal Medicine Associates of Waycross, P.C. | Internal Medicine | 711 Knight Ave, Waycross, GA 31501-1943 | 2007-07-23 |
| 1891875878 | Randall W Mccarthy | Physician Assistant | 711 Knight Ave, Waycross, GA 31501-1943 | 2006-10-16 |
| 1114007044 | Andrea M Deloach | Nurse Practitioner | 711 Knight Ave, Waycross, GA 31501-1943 | 2006-10-16 |
| 1538143607 | Rhonda O Williams | Internal Medicine | 711 Knight Ave, Waycross, GA 31501-1943 | 2005-12-02 |
| 1306820741 | Jill G Bryant | Internal Medicine | 711 Knight Ave, Waycross, GA 31501-1943 | 2005-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962906115 | Davenport Health Pa | Family Medicine | 1401 Cherokee Drive, Waycross, GA 31501 | 2018-03-22 |
| 1962940478 | Blake Darren Aldridge | Physical Therapy Assistant | 401 Preston Street, Waycross, GA 31501 | 2017-02-03 |
| 1669922142 | Jebediah S. Christy Dds - Waycross Pllc | Dentist | 2271 Memorial Dr, Waycross, GA 31501 | 2016-10-10 |
| 1558721944 | Jana Kirby | Massage Therapist | 1599 Knight Ave., Kallman Chiropractic Center, Waycross, GA 31501 | 2016-02-29 |
| 1962877001 | Courtney Baldwin | Specialist/Technologist, Other | 2403 Spurgeon St, Waycross, GA 31501 | 2015-12-01 |
| 1912389784 | Grayson Stuart Griffis | Dentist | 2103 Tebeau St., Waycross, GA 31501 | 2015-06-29 |
| 1730561267 | Trishla Amit Desai | Internal Medicine | Memorial Satilla Health, 1900 Tebeau Street, Waycross, GA 31501 | 2015-06-20 |
| 1316330913 | Hanger Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 512 City Blvd Ste H, Waycross, GA 31501 | 2015-03-06 |
| 1942699079 | Jose Ramon Martinez | Anesthesiology | 701 City Blvd, Waycross, GA 31501 | 2015-01-13 |
| 1023356714 | Orthopedics Surgeons of Georgia, LLC | Orthopaedic Surgery | 2015 Alice Street, Waycross, GA 31501 | 2013-01-30 |
| Find all providers in zip 31501 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730561267 | Trishla Amit Desai | Internal Medicine | Memorial Satilla Health, 1900 Tebeau Street, Waycross, GA 31501 | 2015-06-20 |
| 1124441308 | Packer Medical Services,llc | Internal Medicine | 709 Knight Ave, Waycross, GA 31501-1943 | 2014-01-24 |
| 1023227766 | Thomas Joseph Ferrell | Internal Medicine | 3620 Harris Rd, Waycross, GA 31503-0311 | 2007-05-21 |
| 1104847607 | Southeast Internal Medicine PC | Internal Medicine | 406 Riverside Dr, Waycross, GA 31501-5315 | 2006-07-21 |
| 1538185467 | Muhammad Akram | Internal Medicine | 615 Pendleton St, Waycross, GA 31501-4724 | 2006-07-14 |
| 1386922938 | Victor Hugo Urbieta Caceres | Internal Medicine | 1908 Alice St, Waycross, GA 31501-6208 | 2011-08-01 |
| 1891073482 | Roberto Jafet Lopez Vega | Internal Medicine | 1900 Tebeau St, Waycross, GA 31501-6357 | 2011-07-30 |
| 1285881201 | Jawad Sheqwara | Internal Medicine | 1706 Alice St, Waycross, GA 31501-5216 | 2008-08-20 |
| 1104002666 | Prasanna Sampurna Srinagesh | Internal Medicine | 220 Uvalda St, Waycross, GA 31501-4569 | 2008-01-15 |
| 1144420530 | Internal Medicine Associates of Waycross, P.C. | Internal Medicine | 711 Knight Ave, Waycross, GA 31501-1943 | 2007-07-23 |
| Find all providers in WAYCROSS | ||||
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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.