Wallace Ford Martin (NPI# 1487651386, PAC ID# 1850486630) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1487651386 |
| PAC ID by PECOS | 1850486630 |
| Professional Enrollment ID | I20101201000080 |
| Full Name | Wallace Ford Martin |
| Organization Legal Name | GWINNETT SURGICAL ASSOCIATES, LLP |
| Address |
631 Professional Dr Suite 300 Lawrenceville GA 30046-3371 |
| Phone Number | 7709629977 |
| Gender | M |
| Medical School | EMORY UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1979 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 4688850787 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110087 | GWINNETT MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 631 Professional Dr, Suite 300, Lawrenceville, GA 30046-3371 | 7709629977 | GWINNETT SURGICAL ASSOCIATES, LLP |
| 631 Professional Dr, Suite 300, Lawrenceville, GA 30046-3371 | 7709629977 | NORTHSIDE GWINNETT SURGICAL ASSOCIATES, LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | GWINNETT SURGICAL ASSOCIATES, LLP |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jean-claude D Schwartz | General Surgery | Gwinnett Surgical Associates, LLP | 631 Professional Dr, Suite 300, Lawrenceville, GA 30046-3371 |
| Sudhindra K Anegundi | General Surgery | Gwinnett Surgical Associates, LLP | 631 Professional Dr, Suite 300, Lawrenceville, GA 30046-3371 |
| James K Elsey | General Surgery | Gwinnett Surgical Associates, LLP | 631 Professional Dr, Suite 300, Lawrenceville, GA 30046-3371 |
| Street Address |
631 PROFESSIONAL DR SUITE 300 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip | 30046-3371 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Abdul Hafeez | Dermatology | 631 Professional Dr, Suite 110, Lawrenceville, GA 30046-3325 | |
| Opal M Blake | Nurse Practitioner | Gwinnett Pulmonary Group | 631 Professional Dr, Suite 350, Lawrenceville, GA 30046-3370 |
| Lawrence David Kaplan | Internal Medicine | Gwinnett Pulmonary Group | 631 Professional Dr, Suite 350, Lawrenceville, GA 30046-3370 |
| Robert M Harris | Orthopedic Surgery | Hughston Clinic Southeast PC | 631 Professional Dr, Suite 170, Lawrenceville, GA 30046-3392 |
| Sarah Applegarth | Physician Assistant | The Longstreet Clinic, PC | 631 Professional Dr, Suite 240, Lawrenceville, GA 30046-3397 |
| Mark H Epps | Physician Assistant | Hughston Clinic Southeast PC | 631 Professional Dr, Suite 170, Lawrenceville, GA 30046-3392 |
| Vosudesh Karkala Pai | Pulmonary Disease | Gwinnett Pulmonary Group | 631 Professional Dr, Suite 350, Lawrenceville, GA 30046-3370 |
| Brandon Williams | Physician Assistant | Hughston Clinic Southeast PC | 631 Professional Dr, Suite 170, Lawrenceville, GA 30046-3392 |
| Rajesh R Jasani | Pulmonary Disease | Gwinnett Pulmonary Group | 631 Professional Dr, Suite 350, Lawrenceville, GA 30046-3370 |
| John Floyd | Orthopedic Surgery | Hughston Clinic Southeast PC | 631 Professional Dr, Suite 170, Lawrenceville, GA 30046-3392 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chundra Brooks | Nurse Practitioner | Aga Professional Services LLC | 301 Phillip Blvd, Suite A, Lawrenceville, GA 30046 |
| Gail S Hammond | Clinical Social Worker | 295 S Culver St, Suite A, Lawrenceville, GA 30046-3239 | |
| Kenneth L Knight | Clinical Social Worker | 295 S Culver St, Suite A, Lawrenceville, GA 30046-3239 | |
| Robert W Stevens | Chiropractic | 368 W Pike St, Suite 202, Lawrenceville, GA 30046-3240 | |
| Mehdi Kazemzadeh | Optometry | 575 Professional Dr, Suite 100, Lawrenceville, GA 30046-3300 | |
| Raymond L Stovall | Internal Medicine | 575 Professional Dr, Suite 310, Lawrenceville, GA 30046-3300 | |
| Jeffrey D Zwiren | Plastic and Reconstructive Surgery | Gwinnett Physician Group,llc | 100 Medical Ctr Blvd, Suite 165, Lawrenceville, GA 30046-3301 |
| Kelly H Scoggins | Nurse Practitioner | Gwinnett Physician Group,llc | 100 Medical Ctr Blvd, Suite 165, Lawrenceville, GA 30046-3301 |
| Pamela A Boyd | Nurse Practitioner | Gastroenterology Specialists of Gwinnett, P.C. | 721 Wellness Way, Suite 100, Lawrenceville, GA 30046-3304 |
| William G Tanner Jr. | Gastroenterology | Gastroenterology Specialists of Gwinnett, P.C. | 721 Wellness Way, Suite 100, Lawrenceville, GA 30046-3304 |
| Find all physicians in zip 30046 | |||
| City | LAWRENCEVILLE |
| Zip Code | 30046 |
| Specialty | GENERAL SURGERY |
| City + Specialty | LAWRENCEVILLE + GENERAL SURGERY |
Please comment or provide details below to improve the information on Wallace Ford Martin.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.