Jason D Beaver (NPI# 1740285931, PAC ID# 6800700709) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1740285931 |
| PAC ID by PECOS | 6800700709 |
| Professional Enrollment ID | I20031114000587 |
| Full Name | Jason D Beaver |
| Organization Legal Name | WIREGRASS CLINIC LLC |
| Address |
4370 W Main St Dothan AL 36305-1056 |
| Phone Number | 3347934613 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE |
| Graduation Year | 1996 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 2860662491 |
| Number of Group Practice Members | 37 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 010055 | FLOWERS HOSPITAL |
| 111305 | MILLER COUNTY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4300 W Main St, Dothan, AL 36305-1058 | WIREGRASS CLINIC LLC | |
| 4370 W Main St, Dothan, AL 36305-1056 | 3347934613 | WIREGRASS CLINIC LLC |
| Organization Legal Name | WIREGRASS CLINIC LLC |
| Physicians | 37 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Meaghan S Taylor | Nurse Practitioner | Wiregrass Clinic LLC | 2910 Hospital Dr, Bonifay, FL 32425-4268 |
| Ivan D Jackson | Internal Medicine | Wiregrass Clinic LLC | 210 Westside Dr, Dothan, AL 36303-1928 |
| Jennifer M Parrish | Nurse Practitioner | Wiregrass Clinic LLC | 348 Healthwest Dr, Dothan, AL 36303-1907 |
| Emily Jones | Family Medicine | Wiregrass Clinic LLC | 108 Medical Dr, Dothan, AL 36303-6902 |
| Samantha P Carter | Nurse Practitioner | Wiregrass Clinic LLC | 4300 W Main St, Suite 16, Dothan, AL 36305-1310 |
| Charles J Carpenter Jr. | General Surgery | Wiregrass Clinic LLC | 4370 W Main St, Dothan, AL 36305-1056 |
| J. Douglas Duke Ii | General Surgery | Wiregrass Clinic LLC | 4370 W Main St, Dothan, AL 36305-1056 |
| Jason Lee Cox | Nurse Practitioner | Wiregrass Clinic LLC | 4300 W Main St, Suite 21, Dothan, AL 36305-1058 |
| Tina Cochran | Nurse Practitioner | Wiregrass Clinic LLC | 4300 W Main St, Suite 41, Dothan, AL 36305-1318 |
| John J Marsella Jr. | Anesthesiology | Wiregrass Clinic LLC | 4300 W Main St, Suite 405, Dothan, AL 36305-1086 |
| Street Address |
4370 W MAIN ST |
| City | DOTHAN |
| State | AL |
| Zip | 36305-1056 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael A Allen | Certified Registered Nurse Anesthetist (crna) | Dothan Anesthesiology Associates PC | 4370 W Main St, Dothan, AL 36305-1056 |
| Stephen L Hughes | Anesthesiology | Dothan Anesthesiology Associates PC | 4370 W Main St, Dothan, AL 36305-1056 |
| Ebima C Okundaye | Internal Medicine | App of Alabama Hm, LLC | 4370 W Main St, Dothan, AL 36305-1056 |
| Charles J Carpenter Jr. | General Surgery | Wiregrass Clinic LLC | 4370 W Main St, Dothan, AL 36305-1056 |
| Manzoor Ali | Emergency Medicine | App of Alabama Hm, LLC | 4370 W Main St, Dothan, AL 36305-1056 |
| George B Baxter | Internal Medicine | Northern Alabama Physicians, LLP | 4370 W Main St, Dothan, AL 36305-1056 |
| Gina Marie Hall | Nurse Practitioner | App of Alabama Ed Pllc | 4370 W Main St, Dothan, AL 36305-1056 |
| Cynthia R Cherry | Certified Registered Nurse Anesthetist (crna) | Dothan Anesthesiology Associates PC | 4370 W Main St, Dothan, AL 36305-1056 |
| J. Douglas Duke Ii | General Surgery | Wiregrass Clinic LLC | 4370 W Main St, Dothan, AL 36305-1056 |
| Fnu Ravi | Family Medicine | App of Alabama Hm, LLC | 4370 W Main St, Dothan, AL 36305-1056 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Norma Faye Mcknight | Nurse Practitioner | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Kelli N Heer | Physician Assistant | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Robert M Hagler | Obstetrics/gynecology | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Tonia L Ruddock | Dermatology | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Laura M Tamburin | Dermatology | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Candace N Short | Nurse Practitioner | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| James Butler | Obstetrics/gynecology | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Craig D Omohundro | Dermatology | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Philip Mathew Dozier | Obstetrics/gynecology | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Christopher E Nicholls | Obstetrics/gynecology | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Find all physicians in zip 36305 | |||
| City | DOTHAN |
| Zip Code | 36305 |
| Specialty | GENERAL SURGERY |
| City + Specialty | DOTHAN + 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.