MR. RAYMOND EUGENE POLK (NPI# 1467454314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467454314 |
| Entity Type | Individual |
| Full Name | MR. RAYMOND EUGENE POLK |
| Credential | PA-C |
| Practice Address |
134 Ansley Dr Ste 400 Dahlonega GA 30533-1642 |
| Mailing Address |
Po Box 742616 Atlanta GA 30374-2616 |
| Practice Telephone | 7068641580 |
| Practice Fax Number | 7702199561 |
| Mailing Telephone | 7702198420 |
| Mailing Fax Number | 7702198440 |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2018-05-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
002539 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 100000066A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 59 Tipton Dr, Dahlonega, GA 305331603 | 7068644012 |
| Street Address |
134 ANSLEY DR STE 400 |
| City | DAHLONEGA |
| State | GA |
| Zip Code | 30533-1642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700378197 | Tonya Michelle Smith Moretz | Nurse Practitioner | 134 Ansley Dr Ste 400, Dahlonega, GA 30533 | 2018-06-01 |
| 1083148860 | Tara Brayboy | Internal Medicine | 134 Ansley Dr Ste 400, Dahlonega, GA 30533-1642 | 2017-04-18 |
| 1932169299 | Vickie Simmons | Family Medicine | 134 Ansley Dr Ste 400, Dahlonega, GA 30533 | 2006-03-23 |
| 1841271343 | Donna Winkler Whitfield | Internal Medicine | 134 Ansley Dr Ste 400, Dahlonega, GA 30533-1642 | 2005-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093320244 | Brittany Jamison | Speech-Language Pathologist | 180 Horizon Drive, Dahlonega, GA 30533 | 2020-09-14 |
| 1386109718 | Leanna Scoggin | Specialist/Technologist | 50 Hawksnest Dr, Apt. 300, Dahlonega, GA 30533 | 2019-02-11 |
| 1558753665 | Chelsey Park Health & Rehabilitation LLC | Skilled Nursing Facility | 200 Mountain Park Drive, Dahlonega, GA 30533 | 2015-02-26 |
| 1609286574 | Lanier Dental Group, Inc | Clinic/Center | 5458 S Chestatee, Dahlonega, GA 30533 | 2014-05-01 |
| 1265787444 | Lumpkin County Emergency Medical Services | Ambulance | 57a Pine Tree Way, Dahlonega, GA 30533 | 2012-07-13 |
| 1750651170 | Karen Lee Barrett | Nurse Practitioner | 82 College Ln, Dahlonega, GA 30533 | 2012-01-02 |
| 1427333095 | Dahlonega Pediatric and Adolescent Medicine | Pediatrics | 1055 North Grove St., Dahlonega, GA 30533 | 2011-10-14 |
| 1851690259 | Anselm Kwaku Addo | Pharmacist | 566 East Main St, Dahlonega, GA 30533 | 2011-03-24 |
| 1497064810 | The Maher Rehabilitation Institute LLC | Physical Therapist | 155 Sunset Drive, Dahlonega, GA 30533 | 2010-10-04 |
| 1639498926 | Georgia Mountains Community Services | Day Training, Developmentally Disabled Services | 1220 Pecks Mill Road, Dahlonega, GA 30533 | 2010-05-26 |
| Find all providers in zip 30533 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447429683 | Lindsey Watson Haynes | Physician Assistant | 24 Alicia Lane, Ste 7, Dahlonega, GA 30533-1637 | 2008-02-21 |
| 1023064490 | James G Pairmore | Physician Assistant | 59 Tipton Dr, Dahlonega, GA 30533-1603 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245838374 | Erica Elizabeth West | Physician Assistant | 1155 Mount Vernon Hwy Ste 101, Atlanta, GA 30338-5439 | 2020-10-12 |
| 1801402888 | Meredith Gaines | Physician Assistant | 603 W 1st St Unit 1, Rome, GA 30161-3067 | 2020-09-16 |
| 1770108805 | Kelsey Lynne Greeff | Physician Assistant | 3400 Old Milton Pkwy Ste C, Alpharetta, GA 30005-3707 | 2020-06-15 |
| 1518596733 | Rebecca Faye Tsyrlin | Physician Assistant | 2655 Dallas Hwy Sw Ste 340, Marietta, GA 30064-7518 | 2020-04-08 |
| 1487291878 | Ashley Cohen | Physician Assistant | 250 E Ponce De Leon Ave Ste 800, Decatur, GA 30030-3438 | 2019-12-04 |
| 1932757606 | Andrea J Holley | Physician Assistant | 1629 Austin Meadows Dr, Decatur, GA 30032-3888 | 2019-08-27 |
| 1265089759 | Alexis Chester Jones | Physician Assistant | 3000 Old Alabama Rd # 128, Johns Creek, GA 30022-5860 | 2019-08-20 |
| 1841851680 | Lauren Price Fogarty | Physician Assistant | 5445 Meridian Marks Rd Ste 430, Atlanta, GA 30342-4755 | 2019-06-24 |
| 1386208262 | Jessica A Drews | Physician Assistant | 2342 Cortez Way Ne, Brookhaven, GA 30319-3914 | 2019-04-26 |
| 1174187421 | Krisna Patel | Physician Assistant | 1805 Honey Creek Cmns Se Ste B, Conyers, GA 30013-5829 | 2019-04-23 |
| Find all providers with the same taxonomy | ||||
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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.