Mariah W Thaxton (NPI# 1174841647, PAC ID# 5294867826) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1174841647 |
| PAC ID by PECOS | 5294867826 |
| Professional Enrollment ID | I20100901000236 |
| Full Name | Mariah W Thaxton |
| Organization Legal Name | GWINNETT CARDIOLOGY SERVICES LLC |
| Address |
755 Walther Rd Suite 130 Lawrenceville GA 30046-8725 |
| Phone Number | 6783281766 |
| Gender | F |
| Medical School | MEDICAL COLLEGE OF GEORGIA |
| Graduation Year | 2009 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 6406091248 |
| Number of Group Practice Members | 66 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110087 | GWINNETT MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 755 Walther Rd, Suite 130, Lawrenceville, GA 30046-8725 | 6783281766 | GWINNETT CARDIOLOGY SERVICES LLC |
| 755 Walther Rd, Lawrenceville, GA 30046-8725 | 6783281766 | GWINNETT CARDIOLOGY SERVICES LLC |
| Organization Legal Name | GWINNETT CARDIOLOGY SERVICES LLC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sean E Delaney | Cardiovascular Disease (cardiology) | Gwinnett Cardiology Services LLC | 1000 Medical Ctr Blvd, Lawrenceville, GA 30046-7694 |
| Patrick Mcanally | Physician Assistant | Gwinnett Cardiology Services LLC | 1000 Medical Ctr Blvd, Lawrenceville, GA 30046-7694 |
| Khalid J Hayat | Cardiovascular Disease (cardiology) | Gwinnett Cardiology Services LLC | 1000 Medical Ctr Blvd, Lawrenceville, GA 30046-7694 |
| Thomas Chester Raduszewski | Nurse Practitioner | Gwinnett Cardiology Services LLC | 1000 Medical Ctr Blvd, Lawrenceville, GA 30046-7694 |
| Jim M. John | Cardiovascular Disease (cardiology) | Gwinnett Cardiology Services LLC | 1000 Medical Ctr Blvd, Lawrenceville, GA 30046-7694 |
| Rosalee M Gobeille-dormio | Nurse Practitioner | Gwinnett Cardiology Services LLC | 755 Walther Rd, Suite 130, Lawrenceville, GA 30046-8725 |
| James E Barnhill Iii | Cardiovascular Disease (cardiology) | Gwinnett Cardiology Services LLC | 755 Walther Rd, Lawrenceville, GA 30046-8725 |
| Stacey Ann Philip | Physician Assistant | Gwinnett Cardiology Services LLC | 755 Walther Rd, Suite 130, Lawrenceville, GA 30046-8725 |
| Denise K Krackenberger | Nurse Practitioner | Gwinnett Cardiology Services LLC | 755 Walther Rd, Suite 130, Lawrenceville, GA 30046-8725 |
| Patricia J Eubank | Physician Assistant | Gwinnett Cardiology Services LLC | 755 Walther Rd, Lawrenceville, GA 30046-8725 |
| Street Address |
755 WALTHER RD SUITE 130 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip | 30046-8725 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mandy C Stout | Physician Assistant | Cvg Physicians Group, LLC | 755 Walther Rd, Lawrenceville, GA 30046-8725 |
| Lance B Friedland | Cardiovascular Disease (cardiology) | Cvg Physicians Group, LLC | 755 Walther Rd, Lawrenceville, GA 30046-8725 |
| Olufunso W Odunukan | Interventional Cardiology | Cvg Physicians Group, LLC | 755 Walther Rd, Lawrenceville, GA 30046-8725 |
| Rosalee M Gobeille-dormio | Nurse Practitioner | Gwinnett Cardiology Services LLC | 755 Walther Rd, Suite 130, Lawrenceville, GA 30046-8725 |
| James E Barnhill Iii | Cardiovascular Disease (cardiology) | Gwinnett Cardiology Services LLC | 755 Walther Rd, Lawrenceville, GA 30046-8725 |
| Stacey Ann Philip | Physician Assistant | Gwinnett Cardiology Services LLC | 755 Walther Rd, Suite 130, Lawrenceville, GA 30046-8725 |
| Denise K Krackenberger | Nurse Practitioner | Gwinnett Cardiology Services LLC | 755 Walther Rd, Suite 130, Lawrenceville, GA 30046-8725 |
| Patricia J Eubank | Physician Assistant | Gwinnett Cardiology Services LLC | 755 Walther Rd, Lawrenceville, GA 30046-8725 |
| Laurence M. Lesser | Cardiovascular Disease (cardiology) | Gwinnett Cardiology Services LLC | 755 Walther Rd, Suite 130, Lawrenceville, GA 30046-8725 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chundra Brooks | Nurse Practitioner | Aga Professional Services LLC | 301 Phillip Blvd, Suite A, Lawrenceville, GA 30046 |
| Gail S Hammond | Clinical Social Worker | 295 S Culver St, Suite A, Lawrenceville, GA 30046-3239 | |
| Kenneth L Knight | Clinical Social Worker | 295 S Culver St, Suite A, Lawrenceville, GA 30046-3239 | |
| Robert W Stevens | Chiropractic | 368 W Pike St, Suite 202, Lawrenceville, GA 30046-3240 | |
| Mehdi Kazemzadeh | Optometry | 575 Professional Dr, Suite 100, Lawrenceville, GA 30046-3300 | |
| Raymond L Stovall | Internal Medicine | 575 Professional Dr, Suite 310, Lawrenceville, GA 30046-3300 | |
| Jeffrey D Zwiren | Plastic and Reconstructive Surgery | Gwinnett Physician Group,llc | 100 Medical Ctr Blvd, Suite 165, Lawrenceville, GA 30046-3301 |
| Kelly H Scoggins | Nurse Practitioner | Gwinnett Physician Group,llc | 100 Medical Ctr Blvd, Suite 165, Lawrenceville, GA 30046-3301 |
| Pamela A Boyd | Nurse Practitioner | Gastroenterology Specialists of Gwinnett, P.C. | 721 Wellness Way, Suite 100, Lawrenceville, GA 30046-3304 |
| William G Tanner Jr. | Gastroenterology | Gastroenterology Specialists of Gwinnett, P.C. | 721 Wellness Way, Suite 100, Lawrenceville, GA 30046-3304 |
| Find all physicians in zip 30046 | |||
| City | LAWRENCEVILLE |
| Zip Code | 30046 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | LAWRENCEVILLE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Mariah W Thaxton.
| 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.