Anthony Keith Martin (NPI# 1477570927, PAC ID# 0042299190) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1477570927 |
| PAC ID by PECOS | 0042299190 |
| Professional Enrollment ID | I20101129000182 |
| Full Name | Anthony Keith Martin |
| Organization Legal Name | COLISEUM PRIMARY CARE SERVICES, LLC |
| Address |
340 Hospital Dr Macon GA 31217-3838 |
| Gender | M |
| Medical School | MERCER UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1988 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 7012943152 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110164 | COLISEUM MEDICAL CENTERS, LLC, DBA |
| 110107 | MEDICAL CENTER, NAVICENT HEALTH (THE) |
| 110201 | COLISEUM NORTHSIDE HOSPITAL |
| 110069 | HOUSTON MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 330 Hospital Dr, Suite 315, Macon, GA 31217-8042 | 4787508606 | COLISEUM PRIMARY CARE SERVICES, LLC |
| 340 Hospital Dr, Macon, GA 31217-3838 | COLISEUM PRIMARY CARE SERVICES, LLC | |
| 350 Hospital Dr, Macon, GA 31217-3838 | 4787657000 | COLISEUM PRIMARY CARE SERVICES, LLC |
| Organization Legal Name | COLISEUM PRIMARY CARE SERVICES, LLC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael B Evans | Neurology | Coliseum Primary Care Services, LLC | 350 Hospital Dr, Macon, GA 31217-3838 |
| Sourabh A Lahoti | Neurology | Coliseum Primary Care Services, LLC | 380 Hospital Dr, Bldg A, Macon, GA 31217-8001 |
| William Patrick Roche Iv | Neurology | Coliseum Primary Care Services, LLC | 380 Hospital Dr, Bldg A, Macon, GA 31217-8001 |
| Ginger K Hirsch | Nurse Practitioner | Coliseum Primary Care Services, LLC | 380 Hospital Dr, Suite 320, Macon, GA 31217-8007 |
| Norman Arthur Hetzler Jr. | Thoracic Surgery | Coliseum Primary Care Services, LLC | 340 Hospital Dr, Macon, GA 31217-3838 |
| Joseph J Bear | Urology | Coliseum Primary Care Services, LLC | 380 Hospital Dr, Bldg A, Macon, GA 31217-8001 |
| Maurice F Arnold Ii | General Surgery | Coliseum Primary Care Services, LLC | 340 Hospital Dr, Macon, GA 31217-3838 |
| Leslie K Tomek | Psychiatry | Coliseum Primary Care Services, LLC | 380 Hospital Dr, Bldg A, Macon, GA 31217-8001 |
| Street Address |
340 HOSPITAL DR |
| City | MACON |
| State | GA |
| Zip | 31217-3838 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Barry H Blumenthal | Psychiatry | Rappahannock-rapidan Community Services Board | 340 Hospital Dr, Warrenton, VA 20186-3006 |
| Norman Arthur Hetzler Jr. | Thoracic Surgery | Coliseum Primary Care Services, LLC | 340 Hospital Dr, Macon, GA 31217-3838 |
| Maurice F Arnold Ii | General Surgery | Coliseum Primary Care Services, LLC | 340 Hospital Dr, Macon, GA 31217-3838 |
| Ronald D Schmal | Clinical Psychologist | Rappahannock Rapidan Csb | 340 Hospital Dr, Warrenton, VA 20186-3006 |
| Martha A Skinker | Clinical Social Worker | Rappahannock Rapidan Csb | 340 Hospital Dr, Warrenton, VA 20186-3006 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Farhan Siddiqui | Internal Medicine | 535 Coliseum Dr, Macon, GA 31217-0104 | |
| Eulanda L Waller | Occupational Therapy | Waller Occupational Therapy and Consulting, LLC | 315 Christina Ct, Macon, GA 31217-1331 |
| Harold P Katner | Internal Medicine | 180 Emery Hwy, Macon, GA 31217-3656 | |
| Julie Sanders | Nurse Practitioner | River Edge Behavioral Health Center | 175 Emery Hwy, Macon, GA 31217-3692 |
| Sujatha K Reddy | Psychiatry | River Edge Behavioral Health Center | 175 Emery Hwy, Macon, GA 31217-3692 |
| Stephanie M Welch | Nurse Practitioner | River Edge Behavioral Health Center | 175 Emery Hwy, Macon, GA 31217-3692 |
| Rita A Judy | Clinical Social Worker | River Edge Behavioral Health Center | 175 Emery Hwy, Macon, GA 31217-3692 |
| Jacquelyn D. Owens | Certified Clinical Nurse Specialist (cns) | River Edge Behavioral Health Center | 175 Emery Hwy, Macon, GA 31217-3692 |
| Theresa Courtney | Pediatric Medicine | River Edge Behavioral Health Center | 175 Emery Hwy, Macon, GA 31217-3692 |
| Richard L Elliott | Psychiatry | River Edge Behavioral Health Center | 175 Emery Hwy, Macon, GA 31217-3692 |
| Find all physicians in zip 31217 | |||
| City | MACON |
| Zip Code | 31217 |
| Specialty | GENERAL SURGERY |
| City + Specialty | MACON + GENERAL SURGERY |
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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.