Richard S Stack (NPI# 1376519017, PAC ID# 1052531258) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.
| Nation Provider ID (NPI) | 1376519017 |
| PAC ID by PECOS | 1052531258 |
| Professional Enrollment ID | I20180508002087 |
| Full Name | Richard S Stack |
| Organization Legal Name | ARCHBOLD MEDICAL GROUP, INC. |
| Address |
116 Mimosa Dr Suite 2 Thomasville GA 31792-6605 |
| Phone Number | 2292285500 |
| Gender | M |
| Graduation Year | 1986 |
| Primary Specialty | UROLOGY |
| Group Practice PAC ID | 8123196383 |
| Number of Group Practice Members | 55 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110038 | JOHN D ARCHBOLD MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 116 Mimosa Dr, Suite 2, Thomasville, GA 31792-6605 | 2292285500 | ARCHBOLD MEDICAL GROUP, INC. |
| Organization Legal Name | ARCHBOLD MEDICAL GROUP, INC. |
| Physicians | 53 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anna A Gray | Nurse Practitioner | Archbold Medical Group, Inc. | 1090 5th St Se, Cairo, GA 39828-3139 |
| Jessica Lynn Smith | Nurse Practitioner | Archbold Medical Group, Inc. | 2621 E Pinetree Blvd, Thomasville, GA 31792-4840 |
| Timothy Grayson | Urology | Archbold Medical Group, Inc. | 100 Mimosa Dr, Thomasville, GA 31792-6676 |
| Louis G Lee | Gastroenterology | Archbold Medical Group, Inc. | 947 S Broad St, Thomasville, GA 31792-6161 |
| Kristine E Deutsch | Nurse Practitioner | Archbold Medical Group, Inc. | 112 Mimosa Dr, Thomasville, GA 31792-6605 |
| Stanley B Allen | Physician Assistant | Archbold Medical Group, Inc. | 401 Old Albany Rd, Thomasville, GA 31792-4014 |
| Edward L Hall Jr. | General Surgery | Archbold Medical Group, Inc. | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Latarsha L Jones | Nurse Practitioner | Archbold Medical Group, Inc. | 704 S Broad St, Thomasville, GA 31792-6107 |
| Melissa H Porter | Physician Assistant | Archbold Medical Group, Inc. | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Shay B Schie | Nurse Practitioner | Archbold Medical Group, Inc. | 919 S Broad St, Thomasville, GA 31792-6114 |
| Street Address |
116 MIMOSA DR SUITE 2 |
| City | THOMASVILLE |
| State | GA |
| Zip | 31792-6605 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Randall Clark | Urology | Archbold Medical Group, Inc. | 116 Mimosa Dr, Suite 2, Thomasville, GA 31792-6605 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stanley B Allen | Physician Assistant | Archbold Medical Group, Inc. | 401 Old Albany Rd, Thomasville, GA 31792-4014 |
| James A Thompson | Certified Clinical Nurse Specialist (cns) | John D. Archbold Memorial Hospital, Inc. | 401 Old Albany Rd, Thomasville, GA 31792-4014 |
| Felicia M Yearby | Nurse Practitioner | John D. Archbold Memorial Hospital, Inc. | 401 Old Albany Rd, Thomasville, GA 31792-4014 |
| Ann T Lucas | Clinical Psychologist | John D. Archbold Memorial Hospital, Inc. | 401 Old Albany Rd, Thomasville, GA 31792-4014 |
| Todd A Hanscom | Chiropractic | 409 E Jackson St, Thomasville, GA 31792-4615 | |
| David A Miller | Physical Medicine and Rehabilitation | 421 E Jackson St, Thomasville, GA 31792-4694 | |
| Albert I Richardson | General Surgery | Southern Vascular Specialists, LLC | 1019 E Jackson St, Thomasville, GA 31792-4789 |
| Karen B Lee | Nurse Practitioner | Southern Vascular Specialists, LLC | 1019 E Jackson St, Thomasville, GA 31792-4789 |
| Stephen W Pearce | Certified Registered Nurse Anesthetist (crna) | Georgia-florida Eye Centers, P.C. | 2282 E Pine Tree Boulevard, Thomasville, GA 31792-4807 |
| Robert D Webb | Ophthalmology | Georgia-florida Eye Centers, P.C. | 2282 E Pine Tree Boulevard, Thomasville, GA 31792-4807 |
| Find all physicians in zip 31792 | |||
| City | THOMASVILLE |
| Zip Code | 31792 |
| Specialty | UROLOGY |
| City + Specialty | THOMASVILLE + UROLOGY |
Please comment or provide details below to improve the information on Richard S Stack.
| 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.