Mariel D Hepburn (NPI# 1851659650, PAC ID# 2163660127) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1851659650 |
| PAC ID by PECOS | 2163660127 |
| Professional Enrollment ID | I20151202000318 |
| Full Name | Mariel D Hepburn |
| Organization Legal Name | TIFT REGIONAL HEALTH SYSTEM, INC. |
| Address |
611 E Washington Ave Ashburn GA 31714-5315 |
| Phone Number | 2295673407 |
| Gender | F |
| Medical School | MOREHOUSE SCHOOL OF MEDICINE |
| Graduation Year | 2012 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 5193619971 |
| Number of Group Practice Members | 254 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110095 | TIFT REGIONAL MEDICAL CENTER |
| 110007 | PHOEBE PUTNEY MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 611 E Washington Ave, Ashburn, GA 31714-5315 | 2295673407 | TIFT REGIONAL HEALTH SYSTEM, INC. |
| Organization Legal Name | TIFT REGIONAL HEALTH SYSTEM, INC. |
| Physicians | 217 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melinda K Knight | Urology | Tift Regional Health System, Inc. | 1815 Old Ocilla Rd, Tifton, GA 31794-1617 |
| Nancy Caroline Roe | Nurse Practitioner | Tift Regional Health System, Inc. | 2735 Central Ave S, Tifton, GA 31794-5645 |
| Joshua Clifton Pridemore | Chiropractic | Tift Regional Health System, Inc. | 1602 Madison Ave, Tifton, GA 31794-3756 |
| Anna M Demott Money | Nurse Practitioner | Tift Regional Health System, Inc. | 416 A E Mcpherson Ave, Nashville, GA 31639-2276 |
| Kyle E Fleck | Orthopedic Surgery | Tift Regional Health System, Inc. | 1610 John Orr Dr, Tifton, GA 31794-3682 |
| Christopher David Floyd | Nurse Practitioner | Tift Regional Health System, Inc. | 1623 Old Ocilla Rd, Tifton, GA 31794-4173 |
| Robert D Koester | Physical Therapy | Tift Regional Health System, Inc. | 2227 Us Hwy 41 N, Tifton, GA 31794 |
| Angela Lynn Vannortwick | Nurse Practitioner | Tift Regional Health System, Inc. | 907 18th St E, Suite 490, Tifton, GA 31794-3684 |
| Jason M Allen | Anesthesiology Assistant | Tift Regional Health System, Inc. | 706 N Parrish Ave, Adel, GA 31620-1538 |
| Lindsey Coffee Mcclain | Nurse Practitioner | Tift Regional Health System, Inc. | 103 E James St, Adel, GA 31620-1504 |
| Street Address |
611 E WASHINGTON AVE |
| City | ASHBURN |
| State | GA |
| Zip | 31714-5315 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sonia C Wiggins | Nurse Practitioner | Tift Regional Health System, Inc. | 611 E Washington Ave, Ashburn, GA 31714-5315 |
| Hoang Lafayette | Podiatry | 611 E Washington Ave, Ashburn, GA 31714-5315 | |
| Randall E Campbell | Physician Assistant | Tift Regional Health System, Inc. | 611 E Washington Ave, Ashburn, GA 31714-5315 |
| Richard Wheeler | Family Medicine | Tift Regional Health System, Inc. | 611 E Washington Ave, Ashburn, GA 31714-5315 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Susan R Ethridge | Nurse Practitioner | 235 E Washington Ave, Ashburn, GA 31714-5224 |
| City | ASHBURN |
| Zip Code | 31714 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | ASHBURN + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Mariel D Hepburn.
| 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.