Benjamin Lee Hicks (NPI# 1184961963, PAC ID# 2163676784) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ANESTHESIOLOGY ASSISTANT.
| Nation Provider ID (NPI) | 1184961963 |
| PAC ID by PECOS | 2163676784 |
| Professional Enrollment ID | I20130207000437 |
| Full Name | Benjamin Lee Hicks |
| Organization Legal Name | PREMIER ANESTHESIA OF GEORGIA LLC |
| Address |
1700 Medical Ctr Way Snellville GA 30078 |
| Phone Number | 7709790200 |
| Gender | M |
| Graduation Year | 2012 |
| Primary Specialty | ANESTHESIOLOGY ASSISTANT |
| Group Practice PAC ID | 6608123724 |
| Number of Group Practice Members | 48 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110192 | EASTSIDE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1700 Medical Ctr Way, Snellville, GA 30078 | 7709790200 | PREMIER ANESTHESIA OF GEORGIA LLC |
| Organization Legal Name | PREMIER ANESTHESIA OF GEORGIA LLC |
| Physicians | 37 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley Ann Mire | Certified Registered Nurse Anesthetist (crna) | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Mark C Ankrom | Anesthesiology Assistant | Premier Anesthesia of Georgia LLC | 11 Upper Riverdale Rd, Riverdale, GA 30274-2600 |
| Jody Meek | Anesthesiology Assistant | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Wayne G Hutchens | Anesthesiology | Premier Anesthesia of Georgia LLC | 11 Upper Riverdale Rd, Riverdale, GA 30274-2600 |
| Brittany E Bradley | Certified Registered Nurse Anesthetist (crna) | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Keith Alan Housman | Anesthesiology | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Cary B Gilman | Anesthesiology | Premier Anesthesia of Georgia LLC | 11 Upper Riverdale Rd, Riverdale, GA 30274-2600 |
| Thien D Quach | Anesthesiology | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Michael Guerzon | Anesthesiology Assistant | Premier Anesthesia of Georgia LLC | 11 Upper Riverdale Rd, Riverdale, GA 30274-2600 |
| Stephanie Alyse Powell | Anesthesiology Assistant | Premier Anesthesia of Georgia LLC | 11 Upper Riverdale Rd, Riverdale, GA 30274-2600 |
| Street Address |
1700 MEDICAL CTR WAY |
| City | SNELLVILLE |
| State | GA |
| Zip | 30078 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley Ann Mire | Certified Registered Nurse Anesthetist (crna) | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Jody Meek | Anesthesiology Assistant | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Brittany E Bradley | Certified Registered Nurse Anesthetist (crna) | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Keith Alan Housman | Anesthesiology | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Thien D Quach | Anesthesiology | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ramanjaneyulu V Dronavalli | Internal Medicine | 2138 Scenic N Hwy A, Snellville, GA 30078 | |
| Geetha Jonnala | Rheumatology | 1567 Janmar Rd, Suite 100, Snellville, GA 30078-0308 | |
| Oyinkansola Akinmade | Physical Therapy | Caretherapy, LLC | 1567 Janmar Rd, Snellville, GA 30078-0309 |
| Allison L Guisasola | Occupational Therapy | Caretherapy, LLC | 1567 Janmar Rd, Snellville, GA 30078-0309 |
| Gregory L Mauldin | Critical Care (intensivists) | Georgia Pulmonary Group PC | 1800 Tree Ln, Suite 200, Snellville, GA 30078-2060 |
| Herman A Kwong | Optometry | 1520 Scenic Hwy N, Snellville, GA 30078-2130 | |
| Naland P Shenoy | Endocrinology | 1600 Medical Way, Suite 200, Snellville, GA 30078-2159 | |
| Karine Gelin | Physician Assistant | Marcy Inpatient Services LLC | 1700 Medical Way, Snellville, GA 30078-2195 |
| Donald C Spoon | Nurse Practitioner | Ga-i Medical Services PC | 1700 Medical Way, Snellville, GA 30078-2195 |
| Haritha R Challa | Internal Medicine | Marcy Inpatient Services LLC | 1700 Medical Way, Snellville, GA 30078-2195 |
| Find all physicians in zip 30078 | |||
| City | SNELLVILLE |
| Zip Code | 30078 |
| Specialty | ANESTHESIOLOGY ASSISTANT |
| City + Specialty | SNELLVILLE + ANESTHESIOLOGY ASSISTANT |
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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.