Edward Kenneth Mark Jr. (NPI# 1619089125, PAC ID# 6709936057) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEUROSURGERY.
| Nation Provider ID (NPI) | 1619089125 |
| PAC ID by PECOS | 6709936057 |
| Professional Enrollment ID | I20150909001939 |
| Full Name | Edward Kenneth Mark Jr. |
| Organization Legal Name | NEUROLOGY, NEUROSURGERY, AND SPINE CLINIC OF SOUTH GEORGIA |
| Address |
4274 N Valdosta Rd Valdosta GA 31602-6814 |
| Phone Number | 9122421234 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF GEORGIA |
| Graduation Year | 1982 |
| Primary Specialty | NEUROSURGERY |
| Group Practice PAC ID | 5496742819 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 4274 N Valdosta Rd, Valdosta, GA 31602-6814 | 9122421234 | NEUROLOGY, NEUROSURGERY, AND SPINE CLINIC OF SOUTH GEORGIA |
| Organization Legal Name | NEUROLOGY, NEUROSURGERY, AND SPINE CLINIC OF SOUTH GEORGIA |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mahmood S Eisa | Neurology | Neurology, Neurosurgery, and Spine Clinic of South Georgia | 4274 N Valdosta Rd, Valdosta, GA 31602-6814 |
| Thomas Hart | Nurse Practitioner | Neurology, Neurosurgery, and Spine Clinic of South Georgia | 4274 N Valdosta Rd, Valdosta, GA 31602-6814 |
| Hernan Nunez Posas Jr. | Neurology | Neurology, Neurosurgery, and Spine Clinic of South Georgia | 4274 N Valdosta Rd, Valdosta, GA 31602-6814 |
| Street Address |
4274 N VALDOSTA RD |
| City | VALDOSTA |
| State | GA |
| Zip | 31602-6814 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mahmood S Eisa | Neurology | Neurology, Neurosurgery, and Spine Clinic of South Georgia | 4274 N Valdosta Rd, Valdosta, GA 31602-6814 |
| Thomas Hart | Nurse Practitioner | Neurology, Neurosurgery, and Spine Clinic of South Georgia | 4274 N Valdosta Rd, Valdosta, GA 31602-6814 |
| Hernan Nunez Posas Jr. | Neurology | Neurology, Neurosurgery, and Spine Clinic of South Georgia | 4274 N Valdosta Rd, Valdosta, GA 31602-6814 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Justin Haskin | Nurse Practitioner | Js Medical Diagnostics, LLC | 3790 Old Us Hwy 41 N, Suite B, Valdosta, GA 31602 |
| Sheri L Swader | Neurology | Js Medical Diagnostics, LLC | 3790 Old Us Hwy 41 N, Suite B, Valdosta, GA 31602 |
| Judit T Sule | Internal Medicine | Js Medical Diagnostics, LLC | 3790 Old Us Hwy 41 N, Suite B, Valdosta, GA 31602 |
| Revajo S Broadwater | Physical Therapy | 3537 N Crossing Circle, Valdosta, GA 31602-1019 | |
| Barbara F Frier | Clinical Social Worker | Valdosta Psychiatric Associates, LLC | 3541 N Crossing Circle, Valdosta, GA 31602-1019 |
| Mary Fulp-pye | Clinical Social Worker | Valdosta Psychiatric Associates, LLC | 3541 N Crossing Circle, Valdosta, GA 31602-1019 |
| Jennifer Kenyon | Clinical Social Worker | Valdosta Psychiatric Associates, LLC | 3541 N Crossing Circle, Valdosta, GA 31602-1019 |
| Joel Leland Morgan | Psychiatry | Valdosta Psychiatric Associates, LLC | 3541 N Crossing Circle, Valdosta, GA 31602-1019 |
| Janice L Breidenstein | Clinical Social Worker | Valdosta Psychiatric Associates, LLC | 3541 N Crossing Circle, Valdosta, GA 31602-1019 |
| Eric Christian Stiefel | Orthopedic Surgery | Valdosta Orthopedic Associates PC | 3527 N Valdosta Rd, Valdosta, GA 31602-1055 |
| Find all physicians in zip 31602 | |||
| City | VALDOSTA |
| Zip Code | 31602 |
| Specialty | NEUROSURGERY |
| City + Specialty | VALDOSTA + NEUROSURGERY |
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| 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.