Gary Davis (NPI# 1861478885, PAC ID# 5890732168) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1861478885 |
| PAC ID by PECOS | 5890732168 |
| Professional Enrollment ID | I20050408000797 |
| Full Name | Gary Davis |
| Organization Legal Name | NES OF SANDUSKY INC |
| Address |
1101 Michigan Ave Logansport IN 46947-1528 |
| Phone Number | 5747537541 |
| Gender | M |
| Credential | MD |
| Medical School | INDIANA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1991 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | EMERGENCY MEDICINE |
| Group Practice PAC ID | 8022311729 |
| Number of Group Practice Members | 13 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 361321 | BARNESVILLE HOSPITAL ASSOCIATION, INC |
| 150072 | MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1101 Michigan Ave, Logansport, IN 46947-1528 | 5747537541 | NES OF SANDUSKY INC |
| Organization Legal Name | NES OF SANDUSKY INC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James R Rudolph | Emergency Medicine | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Timothy J Hodgini | Family Medicine | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Dori A Ditty | Emergency Medicine | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Tai N Duong | Emergency Medicine | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Lorraine Dougherty | Nurse Practitioner | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Misty Michelle Swan | Nurse Practitioner | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Derrick L Williams | Nurse Practitioner | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Angela E Emmons Brule | Emergency Medicine | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Street Address |
1101 MICHIGAN AVE |
| City | LOGANSPORT |
| State | IN |
| Zip | 46947-1528 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sunita T Kaul | Anesthesiology | Northstar Anesthesia of Indiana II LLC | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Pamela L Watterson | Clinical Social Worker | Memorial Hospital | 1101 Michigan Ave, Suite 10, Logansport, IN 46947-1528 |
| Marina Weinstein | Hospitalist | Memorial Hospital | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Kral Varhan | Orthopedic Surgery | Memorial Hospital | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Cory S Neumann | Family Medicine | Memorial Hospital | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| James R Rudolph | Emergency Medicine | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Ganeshan Ramachandran | Orthopedic Surgery | Memorial Hospital | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Beth A Hershberger | Nurse Practitioner | Memorial Hospital | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| John B Zimmerer | Anesthesiology | Northstar Anesthesia of Indiana II LLC | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Timothy J Hodgini | Family Medicine | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher L Castaneda | Certified Registered Nurse Anesthetist (crna) | Northstar Anesthesia of Indiana II LLC | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Dori A Ditty | Emergency Medicine | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Tai N Duong | Emergency Medicine | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Lorraine Dougherty | Nurse Practitioner | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Bruce F Alexander | Certified Registered Nurse Anesthetist (crna) | Northstar Anesthesia of Indiana II LLC | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Rose M Ewing | Nurse Practitioner | Memorial Hospital | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Misty Michelle Swan | Nurse Practitioner | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Carolyn D Cook | Certified Registered Nurse Anesthetist (crna) | Northstar Anesthesia of Indiana II LLC | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Derrick L Williams | Nurse Practitioner | Nes of Sandusky Inc | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Edward A Lebrija | Podiatry | Memorial Hospital | 1101 Michigan Ave, Logansport, IN 46947-1528 |
| Find all physicians in zip 46947 | |||
| City | LOGANSPORT |
| Zip Code | 46947 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | LOGANSPORT + FAMILY MEDICINE |
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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.