Avanelle V Jack (NPI# 1316996671, PAC ID# 7012933344) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1316996671 |
| PAC ID by PECOS | 7012933344 |
| Professional Enrollment ID | I20171130000046 |
| Full Name | Avanelle V Jack |
| Organization Legal Name | COASTAL NEPHROLOGY ASSOCIATES, PC |
| Address |
208 Scranton Connector Suite 117 Brunswick GA 31525-0560 |
| Phone Number | 9122645961 |
| Gender | F |
| Credential | MD |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS |
| Graduation Year | 1995 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | NEPHROLOGY |
| Group Practice PAC ID | 6406893262 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110025 | SOUTHEAST GEORGIA HEALTH SYSTEM- BRUNSWICK CAMPUS |
| 110124 | WAYNE MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 208 Scranton Connector, Suite 117, Brunswick, GA 31525-0560 | 9122645961 | COASTAL NEPHROLOGY ASSOCIATES, PC |
| Organization Legal Name | COASTAL NEPHROLOGY ASSOCIATES, PC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Colette E.f. Lee-lewis | Internal Medicine | Coastal Nephrology Associates, PC | 208 Scranton Connector, Suite 117, Brunswick, GA 31525-0560 |
| Paul A Bowen | Internal Medicine | Coastal Nephrology Associates, PC | 208 Scranton Connector, Suite 117, Brunswick, GA 31525-0560 |
| Street Address |
208 SCRANTON CONNECTOR SUITE 117 |
| City | BRUNSWICK |
| State | GA |
| Zip | 31525-0560 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kacey Miller | Physician Assistant | Heller Family Medicine LLC | 208 Scranton Connector, Suite 120, Brunswick, GA 31525-0561 |
| Kaye Sommer | Occupational Therapy | Heller Family Medicine LLC | 208 Scranton Connector, Suite 120, Brunswick, GA 31525-0561 |
| Angela Haigh | Physical Therapy | Heller Family Medicine LLC | 208 Scranton Connector, Suite 120, Brunswick, GA 31525-0561 |
| Jenny Sharpe | Nurse Practitioner | Heller Family Medicine LLC | 208 Scranton Connector, Suite 120, Brunswick, GA 31525-0561 |
| Jennifer R Heller | Chiropractic | 208 Scranton Connector, Suite 120, Brunswick, GA 31525-0561 | |
| Colette E.f. Lee-lewis | Internal Medicine | Coastal Nephrology Associates, PC | 208 Scranton Connector, Suite 117, Brunswick, GA 31525-0560 |
| Paul A Bowen | Internal Medicine | Coastal Nephrology Associates, PC | 208 Scranton Connector, Suite 117, Brunswick, GA 31525-0560 |
| Joseph P Taverney Jr. | Chiropractic | Dr. Jen Rocks, LLC | 208 Scranton Connector, Brunswick, GA 31525-0561 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary Melissa Schmidt | Family Medicine | Coastal Community Health Services Inc. | 106 Shoopers Way, Suite 1, Brunswick, GA 31525 |
| David T Boczar | Chiropractic | Family Health Chiropractic | 92 Village At Aglynn Place, Brunswick, GA 31525 |
| Jennifer L Boczar | Chiropractic | Family Health Chiropractic | 92 Village At Aglynn Place, Brunswick, GA 31525 |
| Kathy Louise Munro | Clinical Social Worker | Coastal Community Health Services Inc. | 106 Shoopers Way, Suite 1, Brunswick, GA 31525 |
| Jay William Floyd | Family Medicine | Coastal Community Health Services Inc. | 106 Shoopers Way, Suite 1, Brunswick, GA 31525 |
| Wilbur Eugene Brown | Chiropractic | Family Health Chiropractic | 92 Village At Aglynn Place, Brunswick, GA 31525 |
| John B Mclaulin | Geriatric Psychiatry | 106 Shoppers Way, Suite 115, Brunswick, GA 31525-0522 | |
| Robert E Holland | Psychiatry | 106 Shoppers Way, Suite 115, Brunswick, GA 31525-0522 | |
| Amber L Wellman | Chiropractic | Wellman Family Healthcare | 124 Chapel Crossing Rd, Brunswick, GA 31525-0529 |
| Robert Wellman | Chiropractic | Wellman Family Healthcare | 124 Chapel Crossing Rd, Brunswick, GA 31525-0529 |
| Find all physicians in zip 31525 | |||
| City | BRUNSWICK |
| Zip Code | 31525 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | BRUNSWICK + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Avanelle V Jack.
| 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.