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Zackary J Whitaker

  • Male

Medical Specialty

Professional ID

  • NPI: 1518204486
  • PECOS ID: 5395980270
  • Enrollment ID: I20130325000424
  • Credential(MD, DO, DPM):
  • Medical School: Mercer University School Of Medicine
  • Medical School Graduation Year: 2012

Hospital Service

  • Hospital CCN1: 110092
  • Business Name (LBN)1: Dodge County Hospital

Medical Practices

  • Organization Name: First Source Anesthesia Llc
  • Group Practice ID assigned by PECOS: 1951693274
  • Number of Group Practice member: 10

Location

  • Address1: 505 Jenkins St
  • Address2:
  • City: Lagrange
  • State: Georgia
  • Zip Code: 30240
  • Phone Number: (706)407-0161

Location

  • Address1: 615 S Hansell St
  • Address2:
  • City: Thomasville
  • State: Georgia
  • Zip Code: 31792
  • Phone Number: (229)226-2234

Medical Practices

  • Organization Name: Sweet Dreams Nurse Anesthesia, Inc.
  • Group Practice ID assigned by PECOS: 5294823266
  • Number of Group Practice member: 21

Location

  • Address1: 117 Kite Rd
  • Address2:
  • City: Swainsboro
  • State: Georgia
  • Zip Code: 30401
  • Phone Number: (478)289-1100

Location

  • Address1: 901 Griffin Ave
  • Address2:
  • City: Eastman
  • State: Georgia
  • Zip Code: 31023
  • Phone Number: (478)448-4000

Medicare

  • Medicare Assignment: Yes
  • Report Quality of Care to Physician Quality Reporting System (PQRS):
  • Used Electronic health record (EHR):