2013 Provider Directory
2013 Provider Directory - Advantage Peach State
2013 Provider Directory - Advantage Peach State
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<strong>2013</strong> <strong>Provider</strong> <strong>Directory</strong><br />
Advantage by Peach State Health Plan is Coordinated Care plan with a Medicare Advantage<br />
contract and a contract with the Georgia Medicaid program.<br />
H7173_ProvPhar<strong>Directory</strong> CMS (Accepted/Approved): 09/22/2012<br />
PSHP-GA_<strong>Provider</strong>_<strong>Directory</strong>_Cover_ENG_<strong>2013</strong>.indd 1<br />
9/17/12 4:48 PM
Advantage by Peach State Health Plan (HMO SNP)<br />
<strong>Provider</strong> <strong>Directory</strong><br />
This directory provides a list of Advantage by Peach State Health Plan’s (HMO SNP) (Peach<br />
State) network providers and pharmacies.<br />
This directory is for the following Georgia counties: Fulton, DeKalb and Gwinnett.<br />
This directory is current as of September 2012. Some network providers may have been added<br />
or removed from our network after this directory was printed. We do not guarantee that each<br />
provider is still accepting new members. The inclusion of a pharmacy in this directory does not<br />
guarantee that the pharmacy is open or is at the same location listed.<br />
To get the most up-to-date information about Peach State’s network providers in your area, you<br />
can visit www.pshp.com or call our Member Service Department at 1-877-725-7748, 8:00AM to<br />
8:00PM, 7 days a week. TTY/TDD users should call 711 or 1-800-255-0056.<br />
Advantage by Peach State Health Plan (HMO SNP) is a Coordinated Care Plan with a<br />
Medicare Advantage contract and a contract with the Georgia Medicaid program.<br />
This document is available in alternative formats and languages. To request information in<br />
alternative formats or languages please call our Member Services Department at 1-877-725-7748<br />
(TTY/DDD users should call 711 or 1-800-255-0056.)<br />
Este documento está disponible en formatos e idiomas diferentes, incluso en español.<br />
Comuníquese con Servicios para los Miembros para solicitar información en otros formatos o<br />
idiomas. Llame al 1-877-725-7748 (los usuarios de TTY/DDD deben llamar 711 or 1-800-255-<br />
0056).<br />
H7173_ProvPhar<strong>Directory</strong> CMS (Accepted/Approved): 09/22/2012 1
Section 1 – Introduction<br />
This directory provides a list of Peach State’s network providers and pharmacies. To get detailed<br />
information about your health care coverage, please see your Evidence of Coverage.<br />
You will have to choose one of our network providers who are listed in this directory to be your<br />
Primary Care <strong>Provider</strong> (PCP). The term “PCP” will be used throughout this directory.<br />
Generally, you must get your health care coverage from your PCP.<br />
The “network providers” listed in this directory have agreed to provide you with your health care<br />
coverage. You may go to any of our network providers listed in this directory; however, some<br />
services may require a referral. If you have been going to one network provider, you are not<br />
required to continue going to that same provider. In some cases, you may get covered services<br />
from non-network providers.<br />
If you receive a bill from a non-contracted provider (out of network provider) for services<br />
rendered, do not pay the bill. Please forward the bill to our Member Services Department at<br />
Advantage by Peach State Health Plan<br />
3200 Highlands Parkway SE,<br />
Suite 300<br />
Smyrna, GA 30082<br />
Fax 1 (800) 659-7518<br />
We will review the bill and determine if you have any financial liability. We will notify you of<br />
any financial liability.<br />
You must receive all routine care from plan providers.<br />
Emergency care can always be obtained in or out of the service area from the nearest available<br />
provider. When in the service area you must use plan providers for urgent care. When out of the<br />
service area, urgent care may be obtained from the first available provider. In addition, when out<br />
of the service area you can obtain dialysis treatment from any qualified dialysis provider. If you<br />
obtain routine care from out-of-network providers neither Medicare nor Peach State will be<br />
responsible for the costs.<br />
Beneficiaries must use network pharmacies to access their prescription drug benefit. Benefits,<br />
formulary, pharmacy network, premium and/or co-payments/coinsurance may change on January<br />
1, <strong>2013</strong>.<br />
H7173_ProvPhar<strong>Directory</strong> CMS (Accepted/Approved): 09/22/2012 2
What is the service area for Peach State?<br />
The counties in our service area are listed below:<br />
Fulton, DeKalb and Gwinnett<br />
How do you find Peach State providers and pharmacies in your area?<br />
The provider directory is organized by type of provider, then by county, and city. Look for the<br />
type of provider first (PCP, specialist), then look for your county and city to find a provider close<br />
to your area.<br />
If you have questions about Peach State or require assistance in selecting a PCP, please call our<br />
Member Service Department at 1-877-725-7748, 8:00AM-8:00PM Monday - Sunday.<br />
TTY\TDD users should call 711 or 1-800-255-0056. Or, visit www.pshp.com.<br />
H7173_ProvPhar<strong>Directory</strong> CMS (Accepted/Approved): 09/22/2012 3
TABLE OF CONTENTS<br />
Page<br />
Primary Care <strong>Provider</strong>s................................................................................... 11<br />
Specialist <strong>Provider</strong>s......................................................................................... 22<br />
Hospitals........................................................................................................... 64<br />
Skilled Nursing Facilities ................................................................................ 65<br />
Outpatient Mental Health <strong>Provider</strong>s .............................................................. 66<br />
Pharmacies ...................................................................................................... 68<br />
<strong>Provider</strong> Index.................................................................................................. 85<br />
H7173—ProvPhar<strong>Directory</strong> CMS (Accepted/Approved): mm/dd/yyyy 4
Advantage by Peach State Health Plan HMO SNP (Peach State)<br />
Directorio de Proveedores<br />
Este directorio proporciona una lista de los proveedores y las farmacias de la red de Advantage<br />
by Peach State Health Plan HMO SNP (Peach State).<br />
Este directorio es para los condados de Fulton, DeKalb y Gwinnett.<br />
Este directorio está actualizado desde el 1 de septiembrede 2012. Se puede haber añadido o<br />
eliminado de la lista algunos proveedores de la red después de la impresión de este<br />
directorio. No garantizamos que cada proveedor todavía acepte nuevos miembros. La<br />
inclusión de una farmacia en este directorio no garantiza que la farmacia esté abierta o esté en el<br />
mismo lugar indicado.<br />
Para obtener la información más actualizada sobre la red de proveedores y farmacias de<br />
Advantage by Peach State en su área, puede visitar www.pshp.com o llamar a nuestro<br />
Departamento de servicios para los miembros al 1-877-725-7748, de 8:00 a.m. a 8:00 p.m., los 7<br />
días de la semana. Si tiene problemas de audición (TDD/TTY), llame al 711 o 1-800-255-0056.<br />
Este directorio está disponible en formatos e idiomas alternativos. Para solicitar<br />
información en formatos o idiomas alternativos, llame a nuestro Departamento de servicios<br />
para los miembros al 1-877-725-7748 (TDD/TTY), 711 o 1-800-255-0056) de 8:00 a.m. a 8:00<br />
p.m., los siete días de la semana.<br />
H7173_ProvPhar<strong>Directory</strong> CMS (Accepted/Approved): 09/22/2012 5
Sección 1 – Introducción<br />
Este directorio proporciona una lista de la red de proveedores y farmacias de Advantage by<br />
Peach State. Para obtener información detallada sobre su cobertura de atención médica, por favor<br />
consulte su Evidencia de cobertura.<br />
Usted tendrá que elegir uno de nuestros proveedores de la red que aparece en este directorio<br />
para que sea su Médico de atención primaria (Primary Care Physician) (PCP). El término<br />
“PCP” se usará en todo este directorio. En general, usted debe obtener su cobertura de<br />
atención médica de su PCP.<br />
Los “proveedores de la red” que aparecen en este directorio están de acuerdo con brindarle su<br />
cobertura de atención médica, vista, audición y dental. Usted puede ir a cualquiera de nuestros<br />
proveedores de la red que aparecen en este directorio, sin embargo algunos servicios pueden<br />
requerir una referencia. Si ha estado consultando con un proveedor de la red, no se<br />
requiere que continúe consultando con el mismo proveedor. En algunos casos, usted puede<br />
recibir servicios cubiertos de proveedores que no están en la red.<br />
Advantage by Peach State es un Plan de necesidades especiales de Medicare Advantage que<br />
tiene contrato de Medicare. Otros proveedores están disponibles en nuestra red.<br />
Si recibe una cuenta de un proveedor no contratado (proveedor fuera de la red) por servicios<br />
prestados, no pague la cuenta. Sírvase enviar la cuenta a la dirección siguiente:<br />
Advantage by Peach State Health Plan HMO SNP Member Services Department<br />
3200 Highlands Parkway, SE, Suite 300<br />
Smyrna, GA 30082<br />
FAX: 800-659-7518<br />
Revisaremos la cuenta y determinaremos si tiene responsabilidad financiera. Le informaremos<br />
sobre cualquier responsabilidad financiera.<br />
Debe recibir toda la atención médica de rutina de proveedores del plan.<br />
H7173_ProvPhar<strong>Directory</strong> CMS (Accepted/Approved): 09/22/2012 6
La atención médica de emergencia siempre se puede obtener dentro o fuera del área de servicio<br />
del proveedor más cercano disponible. Cuando esté en el área de servicio debe usar<br />
proveedores del plan para atención médica de urgencia. Cuando está fuera del área de servicio,<br />
la atención médica de urgencia se puede obtener del primer proveedor disponible. Además,<br />
cuando esté fuera del área de servicio puede obtener tratamiento de la diálisis de cualquier<br />
proveedor de diálisis autorizado. Si recibe atención rutinaria de proveedores fuera de la red, ni<br />
Medicare ni Peach State serán responsables de los costos.<br />
Los beneficiarios deben usar farmacias de la red para acceder a su beneficio de medicamentos<br />
recetados. Los beneficios, el formulario, la red de farmacias, la prima y/o copagos/coseguro<br />
podrían cambiar el 1 de enero de 2011.<br />
H7173_ProvPhar<strong>Directory</strong> CMS (Accepted/Approved): 09/22/2012 7
¿Cuál. es el area de servicio para Advantage by Peach State Health Plan<br />
HMO SNP?<br />
Los condados de nuestra area de servicio son los siguientes:<br />
Fulton, DeKalb y Gwinnett.<br />
H7173_ProvPhar<strong>Directory</strong> CMS (Accepted/Approved): 09/22/2012 8
¿Cómo encuentra proveedores y farmacias de Advantage by Peach State<br />
Health en su área?<br />
Para ubicar a un proveedor de la red más cerca a su hogar, busque bajo el nombre del condado y<br />
la ciudad.<br />
Si tiene preguntas sobre Advantage by Peach State o requiere asistencia para elegir a un<br />
PCP, llame a nuestro Departamento de servicios para los miembros al 1-877-725-7748 de 8:00<br />
a.m. a 8:00 p.m., los 7 días de la semana. Si tiene problemas de audición (TDD/TTY), llame al 1-<br />
800-659-7487. O visite www.pshp.com.<br />
H7173_ProvPhar<strong>Directory</strong> CMS (Accepted/Approved): 09/22/2012 9
ÍNDICE<br />
Página<br />
Proveedores de atención primaria ................................................................ 11<br />
Proveedores especialistas.............................................................................. 22<br />
Hospitals........................................................................................................... 64<br />
Instalación de enfermería especializada ...................................................... 65<br />
Proveedores de salud mental para pacientes ambulatorios ...................... 66<br />
Farmacias......................................................................................................... 68<br />
Índice de proveedores .................................................................................... 85<br />
H7173—ProvPhar<strong>Directory</strong> CMS (Accepted/Approved): mm/dd/yyyy 10
List of Plan <strong>Provider</strong>s<br />
Primary Care Physicians<br />
Family Practice Christie, Jacqueline<br />
MSN*<br />
Goyco, Maria*<br />
4961 Buford Hwy<br />
Manlove-Simmons, Kris<br />
MD*<br />
Cobb County 2227 Idlewood Rd Atlanta, GA 30341 4367 New Snapfinger<br />
Tucker, GA 30084 770-220-2908 Wood Dr<br />
Levarity-Conley, Kristy* 678-205-2039 Decatur, GA 30035<br />
1025 Veterans Memorial Grant, Anne PA* 770-981-2008<br />
Pkwy Clopton, Charles MD* 833 North Hairston Rd<br />
Ste 720 195 Fairview Rd Stone Mountain, GA Martinez-Barnes, Maria<br />
Mableton, GA 30126 Ellenwood, GA 30294 30083 FNP*<br />
678-819-7870 770-507-0112 770-879-5553 1760 Candler Rd<br />
Decatur, GA 30032<br />
DeKalb County Clopton, Charles MD* Harper, Kenneth MD* 404-286-2215<br />
195 Fairview Rd 5910 Hillandale Dr<br />
Alexander, Ruben* Ellenwood, GA 30294 Ste 301 Martinez-Barnes, Maria<br />
5014 Snapfinger Woods 770-507-0112 Lithonia, GA 30058 FNP*<br />
Dr 678-418-2120 770 Village Square Dr<br />
Decatur, GA 30035 Dania, Frank MD*<br />
Stone Mountain, GA<br />
770-981-2008 4480 Covington Highway Ibraheem, Musibau* 30083<br />
Ste B 4150 Snapfinger Woods 404-286-2215<br />
Ali, Kareem MD* Decatur, GA 30035 Dr<br />
2362 Main St 404-288-4027 Ste 230 Midha, Raju MD*<br />
Tucker, GA 30084 Decatur, GA 30035 2680 Lawrenceville Hwy<br />
770-938-4093 Dansby, Davina* 404-289-9784 Ste 100<br />
715 Village Square Dr Decatur, GA 30033<br />
Ali, Kareem MD* Stone Mountain, GA Kwon, Yong PA* 770-492-8665<br />
3 Corporate Blvd Ne Ste 30083 2830 Clearview Place<br />
130 404-299-8444 Suite 210 Molina, Adolfo MD*<br />
Atlanta, GA 30329 Atlanta, GA 30340 3182 Shallowford Road<br />
404-634-1556 Desai, Rohit MD* 678-205-2670 Chamblee, GA 30341<br />
1183 S Hairston Rd 770-457-5758<br />
Anderson, William* Ste A Kwon, Yong PA*<br />
8225 Mall Parkway Stone Mountain, GA 5677 Buford Hwy Monett, Robert*<br />
Ste 100 30088 Ste 210 200 E Ponce De Leon Ave<br />
Lithonia, GA 30038 404-296-8858 Doraville, GA 30340 Ste 110<br />
770-981-2100 678-547-1045 Decatur, GA 30030<br />
Dixon, Martin* 404-377-3436<br />
Andrews, Andrea MD* 4367 Snapfinger Woods Lewis, Joyce*<br />
2491 Panola Rd Dr 3700 Market St Moore-Ruffin, Jada MD*<br />
Lithonia, GA 30058 Decatur, GA 30035 Bldg C 1550 Hosea L Williams Dr<br />
678-205-4999 770-981-2100 Clarkston, GA 30021 Ne<br />
404-298-9333 Atlanta, GA 30317<br />
Ash, Zavier MD* Faulkner, Linda NP* 404-373-5751<br />
5470 Memorial Dr 1418 Scott Blvd Lewis, Joyce*<br />
Ste A Decatur, GA 30030 4434 Jonesboro Rd Moore-Ruffin, Jada MD*<br />
Stone Mountain, GA 770-626-5760 Clarkston, GA 30021 256 Clifton Street SE<br />
30083 404-298-9333 Atlanta, GA 30317-2123<br />
404-296-8500 Gorokhov, Mikhail MD*<br />
404-802-5800<br />
2910 N Druid Hills Rd Ne Li, Hong*<br />
Barclay, Charles* Ste A 3576 Shallowford Rd Ne Moore-Ruffin, Jada MD*<br />
4367 Snapfinger Woods Atlanta, GA 30329-3919 Ste A 35 Whitefoord Ave Se<br />
Dr 404-320-6050 Chamblee, GA 30341 Atlanta, GA 30317<br />
Decatur, GA 30035 770-451-9940 404-588-0104<br />
770-981-2100<br />
Gorokhov, Tatyana MD*<br />
2910 N Druid Hills Rd,<br />
ste A<br />
Atlanta, GA 30329<br />
404-320-6050<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 11<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Primary Care Physicians<br />
List of Plan <strong>Provider</strong>s<br />
Family Practice Reaves, Vera MD* Fulton County Bradley, Cinnamon MD*<br />
cont. 2892 Mountain Industrial 75 Piedmont Avenue<br />
Blvd Abdi, Zia MD*<br />
Ste 700<br />
DeKalb County Tucker, GA 30084 2386 Bolton Rd NW Atlanta, GA 30303<br />
cont. 678-534-0452 Atlanta, GA 30318 404-756-1410<br />
404-352-2810<br />
Moore-Waters, Sondi<br />
Ross, Rhonda MD*<br />
Charkawi, Ahmad MD*<br />
MD*<br />
2496 Columbia Dr Babalola, Dolapo MD* 6300 Hospital Parkway<br />
1428 Scott Blvd<br />
Decatur, GA 30034 1513 East Cleveland Ave Ste 100<br />
Decatur, GA 30030<br />
404-534-9222 Bldg 500<br />
Duluth, GA 30097<br />
404-296-8100 East Point, GA 30344 770-771-6591<br />
Singh, Inder* 404-752-1000<br />
Morton Acker, Terrie<br />
2135 Northlake Pkwy Christie, Jacqueline<br />
MD*<br />
Tucker, GA 30084 Babalola, Dolapo MD* MSN*<br />
3546 Covington Hwy<br />
770-493-1800 1595 W Cleveland 725 North Central Avenue<br />
Ste C Avenue Hapeville, GA 30354-<br />
Decatur, GA 30032 Singh, Varinder MD* East Point, GA 30344 1935<br />
404-284-7744 1462 Montreal Rd 404-616-2886 404-761-2766<br />
Ste 107<br />
Niaz, Saira*<br />
Tucker, GA 30084 Bell-Carter, Denise MD* Clopton, Charles MD*<br />
5900 Hillandale Drive<br />
770-493-1800 1595 W Cleveland Ave 3890 Redwine Rd<br />
Suite 115 Atlanta, GA 30344 Suite 100<br />
Lithonia, GA 30058 Singh, Varinder MD* 404-756-5271 Atlanta, GA 30331<br />
770-322-9660 2135 Northlake Pkwy<br />
Bennett, Cecil MD*<br />
404-349-2273<br />
Tucker, GA 30084<br />
Nimako, Juliet MD*<br />
770-493-1800 285 Boulevard Ne Clopton, Charles MD*<br />
5910 Hillandale Drive Ste 435 3890 Redwine Rd<br />
Ste 301 Tesfaye, Tassew* Atlanta, GA 30337 Ste 100<br />
Lithonia, GA 30058 5300 Memorial Dr 404-524-8950 Atlanta, GA 30331<br />
678-418-2120 Ste 112<br />
Boaten, Afua*<br />
404-349-2273<br />
Stone Mountain, GA<br />
Okobah, Isioma MD*<br />
30083 424 Decatur St SE Daniels, Elvan MD*<br />
2505 Panola Rd<br />
678-704-0306 Atlanta, GA 30313 1513 Cleveland Ave<br />
Ste A 678-843-8600 Atlanta, GA 30344<br />
Lithonia, GA 30058 Tomeh, Bassam MD*<br />
Booker-Roberts, Karla*<br />
404-752-1000<br />
912-293-7546 2536 Lawrenceville Hwy<br />
Decatur, GA 30033 1170 Cleveland Ave Daniels, Elvan*<br />
Okuwobi, Obafemi*<br />
770-934-6832 East Point, GA 30344 1595 Cleveland Ave<br />
1438 McLendon Drive 404-305-350 Atlanta, GA 30334<br />
Decatur, GA 30033 Weston-Hill, Zada MD*<br />
Booker-Roberts, Karla*<br />
404-761-7121<br />
770-414-0337 3290 Memorial Dr<br />
Ste B3<br />
1513 East Cleveland Ave Daya, Shashikant*<br />
Patel, Dharmeshkumar*<br />
Decatur, GA 30032 Bldg 500<br />
3305 Bobby Brown Pkwy<br />
5900 Hillandale Dr<br />
404-474-3301 East Point, GA 30344 Atlanta, GA 30344<br />
Ste B 404-752-1000 404-806-8181<br />
Lithonia, GA 30058 Weston-Hill, Zada MD*<br />
678-205-4999 3644 Chamblee Tucker Booker-Roberts, Karla* Gallaway, Dorothy<br />
Rd<br />
1595 W Cleveland CFNP*<br />
Paulk, Tina NP*<br />
Ste B<br />
Avenue<br />
1350 Boulevard Se<br />
1418 Scott Blvd<br />
Chamblee, GA 30341 East Point, GA 30344 Atlanta, GA 30315<br />
Decatur, GA 30030<br />
770-723-7770 404-616-2886<br />
404-635-1300<br />
770-626-5760<br />
Williams, Eugene MD* Booker-Roberts, Karla* Glodener, Mark MD*<br />
3660 Flat Shoals Road 1920 John Wesley Ave 1845 Lockeway Dr<br />
Ste 250 Atlanta, GA 30337 Ste 404<br />
Decatur, GA 30034 770-513-4000<br />
Alpharetta, GA 30004<br />
404-244-1813 770-343-9112<br />
Page 12<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Primary Care Physicians<br />
Family Practice Kelsey- Harris, Riba Moore-Ruffin, Jada MD* Ramirez, Raymond MD*<br />
cont. MD* 1513 E Cleveland Avenue 936 Holcomb Bridge Rd<br />
1595 Cleveland Ave Bldg 500 Ste 5<br />
Fulton County cont. East Point, GA 30344 East Point, GA 30344 Roswell, GA 30076<br />
Goyco, Maria*<br />
404-761-7121 404-752-1000 770-992-4455<br />
842 North Highland Ave Latif, Mariam MD* Moore-Ruffin, Jada MD* Rust, George*<br />
Ste 200 1865 Lockeway Dr Ste 1595 W Cleveland 1513 East Cleveland Ave<br />
Atlanta, GA 30306 603 Avenue Bldg 500<br />
404-501-7900 Alpharetta, GA 30004 East Point, GA 30344 East Point, GA 30344<br />
Hassanali, Amina*<br />
770-752-8499 404-616-2886 404-752-1000<br />
240 Prospect Place Lin, James MD* Nichols, Michelle MD* Sow, Charles*<br />
Unit E-1 1513 E Cleveland Avenue 1513 E Cleveland Ave 1595 Cleveland Ave<br />
Alpharetta, GA 30005 Bldg 500 Bldg 500 Atlanta, GA 30334<br />
404-929-1402 East Point, GA 30344 Atlanta, GA 30344 404-761-7121<br />
Head, Delphanie MD*<br />
404-752-1000 404-752-1000<br />
Spencer, Leigh*<br />
285 Boulevard NE Lin, James MD* Omole, Folashade MD* 1000 Johnson Ferry Rd<br />
Ste 435 1595 W Cleveland 1513 Cleveland Ave NE<br />
Atlanta, GA 30312 Avenue Bldg 500 Atlanta, GA 30328<br />
404-524-8950 East Point, GA 30344 East Point, GA 30344 404-851-4000<br />
Heiman, Harry MD*<br />
404-616-2886 404-752-1000<br />
Spencer, Leigh*<br />
1513 E Cleveland Avenue Mack, Dominic MD* Omole, Folashade MD* 5901 Peachtree<br />
Bldg 500 1513 Cleveland Ave 1595 Cleveland Ave Dunwoody Rd<br />
East Point, GA 30344 Bldg 500 Atlanta, GA 30334 Ste C-65<br />
404-752-1000 East Point, GA 30344 404-761-7121 Atlanta, GA 30342<br />
Hudson, Richard*<br />
404-752-1000 404-252-9751<br />
Pirtle, Ronald MD*<br />
735 Piedmont Ave Ne Mann, Linda* 1015 Donald Lee Strayhorn, Gregory MD*<br />
Atlanta, GA 30306 1920 John Wesley Ave Hollowell Pkwy 1513 East Cleveland Ave<br />
404-881-6910 Atlanta, GA 30337 Atlanta, GA 30318 Bldg 500<br />
Hussain, Hina MBBS*<br />
770-513-4000 404-523-6571 East Point, GA 30344<br />
5454 Yorktowne Dr<br />
404-752-1000<br />
Martiny, Stephen* Plummer, Valens MD*<br />
Atlanta, GA 30349 4895 Windward Pkwy 1513 Cleveland Ave Strayhorn, Gregory MD*<br />
404-635-6117 Suite 202 Bldg 500 1595 Cleveland Ave<br />
Joshi, Asmita MD*<br />
Alpharetta, GA 30004 East Point, GA 30344 Atlanta, GA 30334<br />
11378 State Bridge Rd<br />
919-794-5878 404-752-1000 404-761-7121<br />
Alpharetta, GA 30022 McNatt, Joshua MD* Plummer, Valens MD* Strothers, Harry MD*<br />
770-449-0990 3193 Howell Mill Rd 1595 W Cleveland Ave 1513 Cleveland Ave<br />
Kazi, Moinuddin*<br />
Ste 306 Atlanta, GA 30344 Bldg 500<br />
4480 N Shallowford Rd<br />
Atlanta, GA 30327-2118 404-756-5271 East Point, GA 30344<br />
Ste 200<br />
404-351-7816 404-756-1000<br />
Powell, Otis MD*<br />
Atlanta, GA 30338 Meng, Yuan-Xiang* 2391 Benjamin E Mays Strothers, Harry MD*<br />
770-455-8285 1513 Cleveland Ave Dr Sw 1595 Cleveland Ave<br />
Kelsey- Harris, Riba<br />
Bldg 500 Atlanta, GA 30311 East Point, GA 30344<br />
MD*<br />
East Point, GA 30344 404-755-2291 404-761-7121<br />
1513 E Cleveland Ave<br />
404-752-1000<br />
Qidwai, Anila MBBS* Tesfaye, Tassew*<br />
Bldg 500 1570 Old Alabama Rd 1046 Ridge Ave<br />
Atlanta, GA 30344 Ste 105 Atlanta, GA 30315<br />
404-752-1000 Roswell, GA 30076-8087 404-688-1350<br />
770-676-6838<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 13<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Primary Care Physicians<br />
List of Plan <strong>Provider</strong>s<br />
Family Practice<br />
cont.<br />
Cameron, Nadia MD*<br />
2000 Riverside Pkwy.<br />
Kwon, Yong PA*<br />
6330 PrimRose Hill Court<br />
Petrey, Carolyn DO*<br />
696 Grayson Hwy<br />
Fulton County cont.<br />
Suite 206<br />
Lawrenceville, GA 30043-<br />
Norcross, GA 30092<br />
770-449-0990<br />
Lawrenceville, GA 30046<br />
770-963-0927<br />
Tesfaye, Tassew*<br />
5926<br />
865-558-3476<br />
Laremont, Benjamin Purohit, Bhumiben MD*<br />
868 York Ave Sw MD* 5075 Peachtree Pkwy<br />
Atlanta, GA 30310 Colac, Olga RN* 4231 Pleasant Hill Rd Ste 106<br />
404-752-1400 2522 Cruse Rd Duluth, GA 30096 Norcross, GA 30092<br />
Williams, Eugene MD*<br />
Ste C-2 678-474-0735 770-582-1300<br />
923 Dill Avenue SW<br />
Lawrenceville, GA 30044<br />
678-225-5540<br />
Muhammad, Angela Ross, Rhonda MD*<br />
Atlanta, GA 30310 MD* 6330 Primrose Hill Ct<br />
404-753-3141 Dansby, Davina* 510 Grayson Hwy Norcross, GA 30092<br />
2121 Fountain Dr Ste A Lawrenceville, GA 30045 770-903-0120<br />
Gwinnett County<br />
Snellville, GA 30078 770-995-9565<br />
770-736-3008<br />
Roy, Deanna MD*<br />
Aguayo, Michele MD*<br />
Nguyen, Kimberly MD* 2080 Sugarloaf Pkwy<br />
2594 Loganville Hwy Ste<br />
Deimler, Robert* 5955 Jimmy Carter Blvd Lawrenceville, GA 30045<br />
101<br />
3550 Centerville Hwy Norcross, GA 30071 770-962-6443<br />
Grayson, GA 30017<br />
Ste 102 770-248-9345<br />
678-225-5546<br />
Snellville, GA 30039<br />
Roy, Deanna MD*<br />
770-985-9957<br />
Nieves, Rafael MD* 6330 Prim Rose Hill Court<br />
Ali, Kareem MD*<br />
5195 Jimmy Carter Ste 100<br />
6330 Primrose Hill Court<br />
Gayle, Wezyann* Boulvard Norcross, GA 30092<br />
Norcross, GA 30092<br />
2080 Sugarloaf Pkwy Suite 100 770-903-0136<br />
770-449-0990<br />
Lawrenceville, GA 30045 Norcross, GA 30093<br />
770-962-6443 770-416-0700<br />
Samuels, Angella CNP*<br />
Anderson, William*<br />
5675 Jimmy Carter Blvd.<br />
4120 Five Forks Trickum Gayle, Wezyann* Okuwobi, Obafemi* Ste 600<br />
Rd Sw<br />
4030 Lawrenceville Hwy 3330 Sugarloaf Parkway Norcross, GA 30071<br />
Ste 104<br />
Ste 9 Ste OL1D 770-255-8990<br />
Lilburn, GA 30047<br />
Lilburn, GA 30047 Lawrenceville, GA 30044<br />
770-935-9546<br />
770-921-4811 678-812-2270<br />
Seok, Woun DO*<br />
3500 Duluth Park Ln<br />
Andrews, Andrea MD*<br />
Gayle, Wezyann* Patel, Dharmeshkumar* Suite 220<br />
1430 Five Forks Trickum 6330 Primrose Hill Court 1430 Five Forks Trickum Duluth, GA 30096<br />
Rd<br />
Norcross, GA 30092 Rd 678-417-0332<br />
Ste 220<br />
770-449-0990 Ste 220<br />
Lawrenceville, GA 30044<br />
Lawrenceville, GA 30044 Sharma, Sangita*<br />
678-578-4983 Gul, Rahim* 678-578-4983<br />
2594 Loganville Hwy Ste<br />
510 Grayson Hwy 101<br />
Attaway, Dean*<br />
Lawrenceville, GA 30045 Patel, Dipak MD* Grayson, GA 30017<br />
4120 Five Forks Trickum 770-995-9565 4745 Nelson Brogdon 678-225-5546<br />
Rd Sw<br />
Blvd<br />
Ste 104 Joshi, Asmita MD* Ste 200<br />
Singh, Inder*<br />
Lilburn, GA 30047 6330 Primrose Hill Court Buford, GA 30518 1533 Pleasant Hill Rd<br />
770-935-9546 Norcross, GA 30092 770-945-7676<br />
Ste 203<br />
770-449-0990 Duluth, GA 30096<br />
Bao, Christine*<br />
Patterson, Veronica* 770-931-3434<br />
777 West Peachtree Kim, Chang-Soo MD* 3625 Braselton Hwy Ste<br />
Street 530 Highland Station Dr 202<br />
Singh, Varinder MD*<br />
Norcross, GA 30071 Ste 2007C Dacula, GA 30019 1533 Pleasant Hill Rd<br />
770-246-6100 Suwanee, GA 30024 770-904-2112<br />
Duluth, GA 30096<br />
770-614-9799 770-931-3434<br />
Page 14<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Primary Care Physicians<br />
Family Practice Chandora, Madhusudan Momin, Musharaf MD* Tran, Steve*<br />
cont. MD* 2701 N Decatur Rd 1364 Clifton Rd NE -<br />
833 North Hairston Rd Decatur, GA 30033 Anesthesiology<br />
Gwinnett County Stone Mountain, GA 404-501-5422 Atlanta, GA 30322<br />
cont. 30083 404-778-3900<br />
770-879-5553<br />
Nagaddya, Lillian*<br />
Smith, Sheila DO*<br />
3424 Flat Shoals Rd Tran, Steve*<br />
696 Grayson Hwy<br />
Duncan, Wallace MD* Decatur, GA 30034 1455 Montreal Rd<br />
Lawrenceville, GA 30046<br />
5900 Hillandale Dr 404-241-5121 Tucker, GA 30084<br />
770-963-0927<br />
Annex E 404-778-6382<br />
Lithonia, GA 30058 Ojo, Olofunso*<br />
Terrelonge, Calvin MD*<br />
770-808-0092<br />
8225 Mall Parkway Ste Watkins, Clyde*<br />
4030 Lawrenceville Hwy<br />
240 5900 Hillandale Drive<br />
Ste 9<br />
Eyzaguirre, William MD* Lithonia, GA 30038 Annex E<br />
Lilburn, GA 30047<br />
5677 Buford Hwy 770-484-3092 Lithonia, GA 30058<br />
770-921-4811<br />
Ste 210 404-446-3870<br />
Doraville, GA 30340 Osinuga, Oladayo MD*<br />
Terrelonge, Calvin MD*<br />
678-547-1045<br />
4348 Klondike Rd Welch, Lisa*<br />
6330 Primrose Hill Court<br />
Lithonia, GA 30038 1290 Columbia Dr<br />
Norcross, GA 30092<br />
Green, Arthur DO* 770-323-7137 Decatur, GA 30032<br />
770-449-0990<br />
2545 Lawrenceville Hwy 404-289-1952<br />
Ste 200<br />
Parikh, Asha MD*<br />
Williams, Tina MD*<br />
Decatur, GA 30033 3 Corporate Square NE Whitehead, Eddie*<br />
6330 Primrose Hill Court<br />
770-934-7876<br />
Suite 130<br />
5900 Hillandale Dr<br />
Norcross, GA 30092<br />
Atlanta, GA 30329 Ste 230<br />
770-449-0990<br />
Harjee, Gulshan* 404-634-1556 Lithonia, GA 30058<br />
Rockdale County<br />
2536 Lawrenceville Hwy 770-593-2382<br />
Decatur, GA 30033 Patel, Nipun MD*<br />
Andrews, Andrea MD* 770-934-6832<br />
3646 Chamblee Tucker Whittaker, Winsome*<br />
2020 Honey Creek Pkwy<br />
Rd Ste D<br />
1046 Ridge Avenue<br />
SE<br />
Johnson, Samuel MD* Atlanta, GA 30341 Atlanta, GA 03015<br />
Conyers, GA 30013<br />
5300 Memorial Dr 770-493-6767 404-564-69<br />
770-929-0813<br />
Ste 112<br />
Stone Mountain, GA Patten, Steven MD* Wills, Noah*<br />
30083<br />
3775 North Druid Hills 2277 Stone Mountain<br />
General Practice<br />
678-704-0306<br />
Road Lithonia Rd<br />
DeKalb County<br />
Decatur, GA 30033-3729 Lithonia, GA 30058<br />
Joseph, Grantley* 404-446-1340 404-241-2336<br />
Huynh, Minh MD* 4153-B Flat Shoals<br />
3603 W Hill St<br />
Parkway<br />
Scharyj, George MD* Wills, Noah*<br />
Clarkston, GA 30021 Suite 200<br />
2545 Lawrenceville Hwy 4229 Snapfinger Woods<br />
404-299-7534<br />
Decatur, GA 30034 Ste 200<br />
Dr<br />
404-585-5049<br />
Decatur, GA 30033 Ste A<br />
Thomas-Cloud,<br />
770-934-7876 Decatur, GA 30035<br />
Rosemary*<br />
Kalu, Uchenna* 404-288-0746<br />
5388 Reuben Ct 2701 N Decatur Rd Schwartz, Terry*<br />
Ellenwood, GA 30294 Decatur, GA 30033 2545 Lawrenceville Hwy You, Alice MD*<br />
678-565-8188<br />
404-501-7925<br />
Ste 200<br />
2505 Chamblee Tucker<br />
Decatur, GA 30033 Rd<br />
Internal Medicine<br />
Miles, Andrea MD* 770-934-7876 Ste 110<br />
8225 Mall Parkway Ste Chamblee, GA 30341<br />
100 Schwartz, Terry*<br />
DeKalb County<br />
770-216-8668<br />
Lithonia, GA 30038 809 Main St<br />
Belachew, Yohannes* 770-981-2100<br />
Stone Mountain, GA<br />
3490 Clairmont Rd Ne<br />
30083<br />
Atlanta, GA 30319<br />
770-469-4131<br />
404-931-1596<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 15<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Primary Care Physicians<br />
List of Plan <strong>Provider</strong>s<br />
Internal Medicine Fotzeu, Claudia MD* Johnson, Khadeja MD* Oderinde, Adesoji MD*<br />
cont. 80 Jesse Hill Jr Dr SE 75 Piedmont Ave NE 80 Jesse Hill Jr Drive SE<br />
Fulton County<br />
Atlanta, GA 30303 Ste 700 Atlanta, GA 30303<br />
404-616-1415 Atlanta, GA 30303 404-616-7578<br />
Aladesanmi, Oluranti<br />
404-756-1410<br />
MD*<br />
Fransua, Mesfin MD*<br />
Omotoso, Irene MD*<br />
75 Piedmont Ave NE<br />
75 Piedmont Ave NE Johnson, Khadeja MD* 75 Piedmont Avenue<br />
Ste 700<br />
Ste 700 80 Jesse Hill Jr Dr Ste 600<br />
Atlanta, GA 30303<br />
Atlanta, GA 30303 Atlanta, GA 30303 Atlanta, GA 30303<br />
404-756-1410<br />
404-756-1410 404-616-5800 404-756-1410<br />
Anderson, David MD*<br />
Fransua, Mesfin MD* Kadree, Margaret MD* Osinuga, Oladayo MD*<br />
75 Piedmont Ave NE<br />
80 Jesse Hill Jr Dr SE 1014 Ralph David 1203 Cleveland Ave<br />
Ste 700<br />
Atlanta, GA 30303 Abernathy Blvd Sw Ste 2D<br />
Atlanta, GA 30303<br />
404-616-4396 Atlanta, GA 30310 Atlanta, GA 30344<br />
404-756-1410<br />
404-755-5555 404-684-7111<br />
Garrett, Stephanie MD*<br />
Blake, Victor MD*<br />
1595 W Cleveland Lloyd, Patricia MD* Parekh, Vishal MD*<br />
75 Piedmont Ave NE<br />
Avenue 340 Boulevard Ne Ste 80 Jesse Hill Jr Dr<br />
Ste 700<br />
East Point, GA 30344 441 Atlanta, GA 30303<br />
Atlanta, GA 30303<br />
404-616-2886 Atlanta, GA 30312 404-616-4307<br />
404-756-1410<br />
404-659-4335<br />
Garrett, Stephanie MD* Parikh, Asha MD*<br />
Blake, Victor MD*<br />
80 Jesse Hill Jr Dr Luster, Karen* 11912 Jones Bridge Rd<br />
80 Jesse Hill Jr Dr SE<br />
Atlanta, GA 30303 80 Jesse Hill Jr Dr SE - Alpharetta, GA 30005<br />
Atlanta, GA 30303<br />
404-616-5800 OB/GYN 678-990-1831<br />
404-616-4396<br />
Atlanta, GA 30303<br />
Green, Arthur DO* 404-616-4646<br />
Parikh, Asha MD*<br />
Buckner, Ayanna*<br />
10700 Medlock Bridge Rd 9570 Nesbit Ferry Road<br />
1513 East Cleveland Ave<br />
Ste 201 Mack, Edward* Ste 100<br />
East Point, GA 30344<br />
Duluth, GA 30097 315 Boulevard Ne Ste Alpharetta, GA 30022<br />
404-752-1000<br />
770-495-3820 444 770-645-1014<br />
Atlanta, GA 30312<br />
Crawford, Marvin MD*<br />
Guan, Shangbo MD* 404-420-0116<br />
Phillips, Christopher<br />
75 Piedmont Ave<br />
275 Carpenter Dr Ne Ste MD*<br />
Ste 700<br />
100 Mbaezue, Nkechi MD* 80 Jesse Hill Jr Dr SE<br />
Atlanta, GA 30303<br />
Atlanta, GA 30328 75 Piedmont Ave NE Ste 100<br />
404-756-1400<br />
404-497-9739 Ste 700 Atlanta, GA 30303<br />
Atlanta, GA 30303 404-616-5800<br />
Elhammali, Balsam MD*<br />
Harris, John MD* 404-756-1410<br />
75 Piedmont Avenue<br />
35 Collier Road NW Rose, Myra MD*<br />
Ste 700<br />
Ste 635 Ngeny, Geoffrey MD* 75 Piedmont Ave NE<br />
Atlanta, GA 30303<br />
Atlanta, GA 30309 80 Jesse Hill Jr Dr SE Ste 700<br />
404-756-1410<br />
404-367-3014 Atlanta, GA 30303 Atlanta, GA 30303<br />
404-616-4396 404-756-1410<br />
Elks, Martha MD*<br />
Ivonye, Chinedu MD*<br />
80 Jesse Hill Jr Dr SE<br />
75 Piedmont Ave NE Oderinde, Adesoji MD* Sanders, Lawrence MD*<br />
Atlanta, GA 30303<br />
Ste 700 1136 Cleveland Ave 1136 Cleveland Ave<br />
404-616-1415<br />
Atlanta, GA 30303 Ste 309 Ste 309<br />
404-756-1410 Atlanta, GA 30344 Atlanta, GA 30344<br />
Foreman, Marilyn MD*<br />
404-762-6564 404-762-6564<br />
75 Piedmont Avenue<br />
Johnson, Charles*<br />
Ste 700<br />
3193 Howell Mill Rd Nw Oderinde, Adesoji MD* Sanders, Lawrence MD*<br />
Atlanta, GA 30303<br />
Ste 306 75 Piedmont Ave 75 Piedmont Ave Ste 700<br />
404-756-1410<br />
Atlanta, GA 30327 Ste 700 Atlanta, GA 30303<br />
404-351-7816 Atlanta, GA 30303 404-756-1410<br />
404-756-1400<br />
Page 16<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Primary Care Physicians<br />
Internal Medicine<br />
cont.<br />
Tran, Steve*<br />
550 Peachtree St NE -<br />
Babalola, Cecilia MD*<br />
3970 Five Forks Trickum<br />
Nguyen, Paul*<br />
4852 Jimmy Carter Blvd<br />
Fulton County cont.<br />
Radiology<br />
Atlanta, GA 30308<br />
Rd<br />
Ste A<br />
Norcross, GA 30093<br />
678-380-9889<br />
Scharyj, George MD*<br />
404-686-2321 Lilburn, GA 30047<br />
770-564-6900<br />
Parikh, Asha MD*<br />
10700 Medlock Bridge Rd Uchegbu, Chukwudi 6330 Primrose Hill Court<br />
Ste 201 MD* Evans, Candice* Norcross, GA 30092<br />
Duluth, GA 30097 3400 Old Milton Parkway 4445 S Lee St 770-449-0990<br />
770-495-3820 Ste 500 Ste 400<br />
Alpharetta, GA 30005 Buford, GA 30518-8805 Parikh, Naresh*<br />
Schwartz, Terry*<br />
678-762-0053 770-932-8519<br />
6010 Singleton Rd<br />
1150 Hammond Dr NE Ste 209<br />
Ste B2140 Vasandani, Geetanjali Eyzaguirre, William MD* Norcross, GA 30093<br />
Atlanta, GA 30328 MD* 2080 Sugarloaf Pkwy 770-248-0200<br />
404-459-8440 1247 Donald Lee Lawrenceville, GA 30045<br />
Hollowell Parkway 770-962-6443<br />
Parikh, Naresh*<br />
Servera, Vigelo MD*<br />
Atlanta, GA 30318<br />
6330 Prim Rose Hill Court<br />
401 S Main St<br />
404-616-2265<br />
Eyzaguirre, William MD* Ste 100<br />
Ste C5 6330 Prim Rose Hill Court Norcross, GA 30092<br />
Alpharetta, GA 30009 Vasandani, Geetanjali Ste 100 770-903-0136<br />
770-521-9128 MD* Norcross, GA 30092<br />
80 Jesse Hill Jr Dr 770-903-0136<br />
Patterson, Veronica*<br />
Sharma, Chandi MD*<br />
Atlanta, GA 30303<br />
3625 Braselton Hwy Ste<br />
2645 Donald Lee<br />
404-616-4307<br />
Inayat, Shah MD* 202<br />
Hollowell Pkwy Nw 5345 Jimmy Carter Dacula, GA 30019<br />
Atlanta, GA 30318 Wade, Thomas* Boulvard 770-904-2112<br />
404-794-0014 1800 Phoenix Blvd Ste Ste I<br />
210 Norcross, GA 30093 Paul, Ranjan*<br />
Sharma, Chandi MD*<br />
Atlanta, GA 30349 770-409-7338<br />
4355 Johns Creek Pkwy<br />
3681 Auditorium Way<br />
770-994-1362<br />
Suite 500<br />
Atlanta, GA 30337 Kim, Jinahn MD* Suwanee, GA 30024<br />
404-766-5361 Watson, Nardia NP* 1325 Satellite Blvd Bldg 770-623-0008<br />
Shepherd, Sharon FNP-<br />
4910 Jonesboro Road 700<br />
Bldg 700 Ste 1<br />
Ste 701A<br />
Rafique, Shahid*<br />
C*<br />
Union City, GA 30291 Suwanee, GA 30024 2331 Henry Clower Blvd<br />
1188 Ralph David<br />
770-964-7736 678-417-1255<br />
Ste A<br />
Abernathy Blvd Sw Snellville, GA 30078<br />
Atlanta, GA 30310 Whittaker, Winsome* Lee, Joon Nam MD* 770-736-1735<br />
404-755-8996 1046 Ridge Ave 6185 Buford Hwy<br />
Atlanta, GA 30315 Bldg G<br />
Rafique, Shahid*<br />
Singh, Rajender MD*<br />
404-688-1350 Norcross, GA 30071 2351 Henry Clower Blvd<br />
9995 Jones Bridge Rd<br />
770-446-0929<br />
Ste B<br />
Alpharetta, GA 30022 Wills, Noah* Snellville, GA 30078<br />
678-366-1200 2578 Gresham Rd SE Motta-Murray, Sheryl* 770-736-1735<br />
Stringer, Harold MD*<br />
Atlanta, GA 30316 3550 Centerville Hwy<br />
404-241-2336 Ste 102<br />
Shah, Suresh*<br />
75 Piedmont Avenue<br />
Snellville, GA 30039 1211 Indiana Trail<br />
Ste 600 Gwinnett County 770-985-9957<br />
Norcross, GA 30093<br />
Atlanta, GA 30303 404-437-7070<br />
404-756-1410 Ajayi, Julius MD* Nariani, Sanjay MD*<br />
2930 Horizon Park Dr Ste 3463A Lawrenceville Shah, Suresh*<br />
Tran, Steve*<br />
C Ste 109<br />
5245 Buford Hwy<br />
4575 N Shallowford Rd Suwanee, GA 30024 Suwanee, GA 30024 Norcross, GA 30071<br />
Atlanta, GA 30338 678-546-2840 678-714-8522<br />
770-447-5551<br />
404-778-6382<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 17<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Primary Care Physicians<br />
List of Plan <strong>Provider</strong>s<br />
Internal Medicine Crenshaw, Yvonka MD* Hutchinson, William* Stephens, Latoya MD*<br />
cont. 2675 North Decatur Road 1805 Parke Plaza Cir 4166 Snapfinger Woods<br />
Ste 604 Ste 102 Drive<br />
Gwinnett County Decatur, GA 30033 Stone Mountain, GA Decatur, GA 30035<br />
cont. 678-904-1150 30087 404-284-3200<br />
Singhal, Sunit MD*<br />
770-469-9961<br />
Daus, Kevin*<br />
Suddala, Satya MD*<br />
5075 Peachtree Pkwy<br />
675 North Decatur Rd Hutchinson, William* 197 Fairview Rd<br />
Ste 106<br />
Ste 404 2179 Northlake Pkwy Ellenwood, GA 30294<br />
Norcross, GA 30092<br />
Decatur, GA 30033 Tucker, GA 30084 770-389-6555<br />
770-582-1300<br />
404-296-1424 770-934-8516<br />
Tucker, George MD*<br />
Syed, Riaz MD*<br />
Dopson, James MD* Hutchinson, William* 3523 Budford Hwy<br />
870 Collins Hill Rd<br />
1918 Northlake Pkwy 2701 N Decatur Rd Ste 100<br />
Lawrenceville, GA 30043<br />
Ste 101 Decatur, GA 30033 Atlanta, GA 30329<br />
678-377-0900<br />
Tucker, GA 30084 404-501-5422 404-634-4550<br />
You, Alice MD* 770-723-9318<br />
Hutchinson, William* Twiddy, Kenneth*<br />
4855 River Green Pkwy<br />
Geltz, Christian* 2801 N Decatur Rd 3114 Mercer Union Dr<br />
Ste 520<br />
1805 Parke Plaza Cir Ste 190 Chamblee, GA 30341<br />
Duluth, GA 30096<br />
Ste 102 Decatur, GA 30033 770-953-4242<br />
678-417-1588<br />
Stone Mountain, GA 404-299-9307<br />
30087<br />
Williams, Andre*<br />
Obstetrics & 770-469-9961<br />
Johnson, Kathleen* 4166 Snapfinger Woods<br />
Gynecology 2675 N Decatur Rd Drive<br />
Geltz, Christian* Ste 512 Decatur, GA 30035<br />
DeKalb County 2701 N Decatur Rd Decatur, GA 30033 404-284-3200<br />
Decatur, GA 30033 404-508-2000<br />
Assevero, Michael*<br />
404-501-5422<br />
Williams, Andre*<br />
4166 Buford Hwy Ne Ste Johnson, Kathleen* 4229 Snapfinger Woods<br />
1029 Geltz, Christian* 2701 N Decatur Rd Dr<br />
Atlanta, GA 30341 2801 DeKalb Medical Decatur, GA 30033 Ste A<br />
404-417-9360 Pkwy 404-501-1000 Decatur, GA 30035<br />
Lithonia, GA 30058 404-288-0746<br />
Carter, John*<br />
404-299-9307<br />
Johnson, Kathleen*<br />
1805 Parke Plaza Cir 5900 Hillandale Dr Fulton County<br />
Ste 102 Geltz, Christian* Ste 200<br />
Stone Mountain, GA 2801 N Decatur Rd Lithonia, GA 30058 Andrews, Valisia MD*<br />
30087 Ste 190 404-508-2000<br />
755 Mount Vernon Hwy<br />
770-469-9961 Decatur, GA 30033<br />
Ne Ste 220<br />
404-299-9307<br />
Kassam, Gulzar* Atlanta, GA 30328<br />
Carter, John* 2675 N Decatur Rd 404-250-3660<br />
2701 N Decatur Rd Hadley, Phillip MD* Ste 604<br />
Decatur, GA 30033 2675 N Decatur RdC Decatur, GA 30033 Assevero, Michael*<br />
404-501-5422 Ste 100 678-904-1150<br />
3699 Bakers Ferry Rd SW<br />
Decatur, GA 30033<br />
Atlanta, GA 30337<br />
Carter, John*<br />
404-292-1144<br />
Raviele, Kathleen MD* 404-765-4164<br />
2801 N Decatur Rd 2167 Northlake Rkwy<br />
Ste 190<br />
Hadley, Phillip MD* Ste 105<br />
Assevero, Michael*<br />
Decatur, GA 30033 2675 North Decatur Rd Tucker, GA 30084 936 Holcomb Bridge Rd<br />
404-299-9307 Ste 707 770-491-0255<br />
Roswell, GA 30076<br />
Decatur, GA 30033<br />
770-992-3777<br />
Carter, John*<br />
404-292-1144<br />
Smith, Dominique*<br />
2801 N Decatur Road 5900 Hillandale Drive<br />
Ste 190<br />
Annex A<br />
Decatur, GA 30033 Lithonia, GA 30058<br />
404-299-9307 678-418-6990<br />
Page 18<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Primary Care Physicians<br />
Obstetrics & Crone, William MD* Gober, Henry MD* Hsiao, Clement MD*<br />
Gynecology cont. 1000 Johnson Ferry RD 5505 Peachtree 5670 Peachtree<br />
Atlanta, GA 30342 Dunwoody Rd Dunwoody Rd NE<br />
Fulton County cont. 404-256-8000 Ste 580 Ste 1240<br />
Atlanta, GA 30342 Atlanta, GA 30342<br />
Assevero, Michael* Crowe, Michael MD* 404-256-6336 770-777-4933<br />
936 Holcomb Bridge 265 Boulevard NE<br />
Road<br />
2nd floor Grant, Jacqueline MD* Jeon, Won CNM*<br />
Roswell, GA 30076 Atlanta, GA 30312 75 Piedmont Avenue 1015 Mansell Road<br />
770-992-3777<br />
404-265-4940 Ste 700 Roswell, GA 30076<br />
Atlanta, GA 30303 678-352-0254<br />
Blank, Stephen MD* Davis Williams, E MD* 404-756-1410<br />
755 Mount Vernon Hwy 550 Peachtree St NE Jeon, Won CNM*<br />
NE<br />
Ste 1470 Hackney, Wendell MD* 980 Johnson Ferry Road<br />
Ste 330<br />
Atlanta, GA 30309 315 Boulevard NE Ste 660<br />
Atlanta, GA 30328 404-589-2670 Ste 336 Atlanta, GA 30342<br />
404-256-2277<br />
Atlanta, GA 30312 404-255-2057<br />
Dunson Allen, Shelley 404-522-4888<br />
Booker-Roberts, Karla* MD*<br />
Joffe, Alan MD*<br />
1170 Cleveland Ave 1305 Hembree Rd Harp, Djana MD* 993 Johnson Ferry Road<br />
East Point, GA 30344 Roswell, GA 30076 1595 Cleveland Ave Ste 120<br />
404-305-350<br />
770-754-4445 Atlanta, GA 30334 Atlanta, GA 30342-1626<br />
404-761-7121 404-256-2811<br />
Booker-Roberts, Karla* Ehrlich, Jonathan MD*<br />
1513 East Cleveland Ave 980 Johnson Ferry Rd Ne Harp, Djana MD* Jones-Bailey, Alise MD*<br />
Bldg 500<br />
Ste 720 75 Piedmont Ave NE 11660 Alpharetta Hwy<br />
East Point, GA 30344 Atlanta, GA 30342 Ste 700 Roswell, GA 30076<br />
404-752-1000<br />
404-252-3898 Atlanta, GA 30303 770-667-9997<br />
404-756-1410<br />
Booker-Roberts, Karla* Ehrlich, Jonathan MD*<br />
Kassam, Gulzar*<br />
1595 W Cleveland 993 Johnson Ferry Rd Harp, Djana MD* 550 Peachtree St Ne<br />
Avenue<br />
Ste 360 80 Jesse Hill Jr Dr SE Ste 1060<br />
East Point, GA 30344 Atlanta, GA 30342 Atlanta, GA 30303 Atlanta, GA 30308<br />
404-616-2886<br />
770-246-4446 404-616-4396 404-581-0307<br />
Booker-Roberts, Karla* Fung, Yun MD* Harp, Jamil MD* Latif, Rhonda MD*<br />
1920 John Wesley Ave 75 Piedmont Ave NE 1595 W Cleveland 265 Boulevard NE<br />
Atlanta, GA 30337 Ste 700 Avenue 2nd floor<br />
770-513-4000<br />
Atlanta, GA 30303 East Point, GA 30344 Atlanta, GA 30312<br />
404-756-1410 404-616-2886 404-265-4940<br />
Braswell, Precious MD*<br />
1920 John Wesley Ave Fung, Yun MD* Harp, Jamil MD* Lemon, Tracey MD*<br />
Atlanta, GA 30337 80 Jesse Hill Jr Dr 75 Piedmont Avenue 285 Boulevard NE<br />
770-513-4000<br />
Atlanta, GA 30303 Ste 700 Ste 410<br />
404-616-4307 Atlanta, GA 30303 Atlanta, GA 30312<br />
Braswell, Precious MD* 404-756-1400 404-265-6888<br />
2885 Headland Drive Geary, Franklyn MD*<br />
East Point, GA 30344 75 Piedmont Avenue Harp, Jamil MD* Lemon, Tracey MD*<br />
404-349-5600<br />
Ste 700 80 Jesse Hill Jr Drive 315 Boulevard NE<br />
Atlanta, GA 30303 Atlanta, GA 30303 Ste 328<br />
Crenshaw, Yvonka MD* 404-756-1400 404-616-4307 Atlanta, GA 30312<br />
550 Peachtree St Ne Ste 404-265-6888<br />
1060<br />
Geary, Franklyn MD* Hsiao, Clement MD*<br />
Atlanta, GA 30308 80 Jesse Hill Jr Dr 3400 Old Milton Pkwy Lemon, Tracey MD*<br />
404-581-0307<br />
Atlanta, GA 30303 Ste 425 35 Linden Ave<br />
404-616-5800 Alpharetta, GA 30005 Atlanta, GA 30308<br />
777-777-7493 404-265-3154<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 19<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Primary Care Physicians<br />
List of Plan <strong>Provider</strong>s<br />
Obstetrics &<br />
Gynecology cont.<br />
Fulton County cont.<br />
Lipscomb-McDaniel,<br />
Kim MD*<br />
1000 Johnson Ferry Rd<br />
NE<br />
Atlanta, GA 30342<br />
404-851-8988<br />
Lipscomb-McDaniel,<br />
Kim*<br />
1015 Mansell Road<br />
Roswell, GA 30076<br />
678-352-0254<br />
Lipscomb-McDaniel,<br />
Kim MD*<br />
1015 Mansell Road<br />
Roswell, GA 30076<br />
404-847-1580<br />
Lipscomb-McDaniel,<br />
Kim MD*<br />
3000 Hospital Blvd<br />
Roswell, GA 30076<br />
770-751-2509<br />
Lipscomb-McDaniel,<br />
Kim MD*<br />
6325 W Johns Crossing<br />
Bldg 100, Ste 209<br />
Duluth, GA 30097<br />
678-805-2246<br />
Lipscomb-McDaniel,<br />
Kim*<br />
6335 Hospital Parkway<br />
Suite 209<br />
Duluth, GA 30097<br />
678-805-2246<br />
Lipscomb-McDaniel,<br />
Kim MD*<br />
980 Johnson Ferry Road<br />
Atlanta, GA 30342<br />
404-847-1580<br />
Lue, John*<br />
315 Boulevard Ne Ste<br />
328<br />
Atlanta, GA 30312<br />
404-522-4400<br />
Marine, Christopher Nassar, Gabriel MD* Spanier, Jacob MD*<br />
MD* 75 Piedmont Avenue 960 Johnson Ferry Rd Ne<br />
1039 Ridge Ave Sw Ste 700 Ste 800<br />
Atlanta, GA 30315 Atlanta, GA 30303 Atlanta, GA 30342<br />
404-688-1350 404-756-1410 404-851-9909<br />
Marine, Christopher Nassar, Gabriel MD* St Julian, Tracey MD*<br />
MD* 80 Jesse Hill Jr Dr 3699 Bakers Ferry Rd SW<br />
2578 Gresham Rd SE Atlanta, GA 30303 Atlanta, GA 30337<br />
Atlanta, GA 30316 404-616-4307 404-765-4164<br />
404-241-2336<br />
Paul, Dara MD* Tucker, G*<br />
Matthews, Roland MD* 3890 Redwine Road 3699 Cascade Rd<br />
75 Piedmont Ave NE Ste 210 Ste A<br />
Ste 700 Atlanta, GA 30331 Atlanta, GA 30331<br />
Atlanta, GA 30303 404-346-3417 404-699-2400<br />
404-756-1410<br />
Purdie, Jill MD* Tucker, George MD*<br />
McBrayer Sr, Daniel* 1015 Mansell Road 265 Boulevard NE<br />
285 Boulevard Ne Ste Roswell, GA 30076 2nd floor<br />
240 678-352-0254 Atlanta, GA 30312<br />
Atlanta, GA 30312 404-265-4940<br />
404-584-8428<br />
Purdie, Jill MD*<br />
6325 Hospital Parkway Vinokur, Lisa MD*<br />
Miller Thrashe, Duluth, GA 30097 1305 Hembree Rd<br />
Melinda* 678-474-7000 Ste 101<br />
550 Peachtree St NE Roswell, GA 30076<br />
Ste 1470 Purdie, Jill MD* 770-754-4445<br />
Atlanta, GA 30309 980 Johnson Ferry Road<br />
404-589-2670<br />
Ste 660<br />
Williams, D’nyce MD*<br />
Atlanta, GA 30342 75 Piedmont Ave NE<br />
Minnis, Jamil MD* 404-255-2057 Ste 700<br />
80 Jesse Hill Jr Dr Atlanta, GA 30303<br />
Atlanta, GA 30303 Scineaux, Tressa MD* 404-756-1410<br />
404-616-5800<br />
1360 Upper Hembree<br />
Road<br />
Gwinnett County<br />
Moore, Bradley MD* Ste 101<br />
9 Dunwoody Park Roswell, GA 30076 Assevero, Michael*<br />
Ste 108 770-817-1970<br />
5127 Jimmy Carter Blvd<br />
Atlanta, GA 30338<br />
Norcross, GA 30093<br />
770-393-1988<br />
Simmons, Lorenza MD* 770-613-0770<br />
315 Boulevard NE<br />
Nassar, Gabriel MD* Ste 336<br />
Crone, William MD*<br />
1136 Cleveland Ave Atlanta, GA 30312 3169 Holcomb Bridge Rd<br />
Ste 600 404-522-4888<br />
Ste 760<br />
Atlanta, GA 30344<br />
Norcross, GA 30071<br />
404-762-7697<br />
Simmons, Lorenza MD* 770-441-1213<br />
6285 Shannon Pkwy<br />
Nassar, Gabriel MD* Union City, GA 30291 Daus, Kevin*<br />
2739 Felton Drive 770-964-4142<br />
1700 Tree Ln<br />
East Point, GA 30344<br />
Ste 210<br />
404-762-7697<br />
Smith, Gregory MD* Snellville, GA 30078<br />
315 Boulevard NE 770-982-0019<br />
Ste 336<br />
Atlanta, GA 30312<br />
404-522-4888<br />
Page 20<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Primary Care Physicians<br />
Obstetrics &<br />
Gynecology cont.<br />
Gwinnett County<br />
cont.<br />
Gober, Henry MD*<br />
4365 Johns Creek Pkwy<br />
Ste 430<br />
Suwanee, GA 30024<br />
404-256-6336<br />
Lipscomb-McDaniel,<br />
Kim MD*<br />
1000 Medical Center Blvd<br />
Lawrenceville, GA 30045<br />
678-442-4321<br />
Lipscomb-McDaniel,<br />
Kim MD*<br />
500 Medical Center Blvd<br />
Ste 210<br />
Lawrenceville, GA 30045<br />
770-822-3344<br />
Oh, Jung MD*<br />
6185 Buford Hwy<br />
Bldg G<br />
Norcross, GA 30071<br />
770-446-0929<br />
Pomerance, Alan*<br />
4120 Five Forks Trickum<br />
Rd Sw<br />
Ste 103<br />
Lilburn, GA 30047<br />
770-396-2496<br />
Purdie, Jill MD*<br />
500 Medical Center Blvd<br />
Ste 210<br />
Lawrenceville, GA 30045<br />
770-822-3344<br />
Soyoola, Emmanuel<br />
MD*<br />
2169 Lawrenceville Hwy<br />
Lawrenceville, GA 30044<br />
770-962-3700<br />
Whitmore, Simone MD*<br />
3460 Summit Ridge<br />
Pkwy, Ste 101<br />
Duluth, GA 30096<br />
678-584-9223<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 21<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Allergy and Rabinowitz, Paul MD* Guydon, Linda MD* Cardiology /<br />
Immunology 5555 Peachtree 4310 Johns Creek Pkwy Cardiovascular<br />
Dunwoody Rd Ne Ste 130<br />
Ste 325 Suwanee, GA 30024<br />
Disease<br />
DeKalb County<br />
Atlanta, GA 30342 770-952-8612 Baldwin County<br />
Chiang, Grace MD* 404-255-9286<br />
1900 Century Blvd NE Nam, Na Kyoung Judy Ahmed, Mirza*<br />
Ste 4<br />
Segall, Nathan MD* MD*<br />
111 Fieldstone Drive<br />
Atlanta, GA 30345 175 Country Club Drive 1780 Presidential Cir Ste 108<br />
404-417-9333 Bldg 100 Ste A Ste 200<br />
Milledgeville, GA 31061<br />
Atlanta, GA 30342 Snellville, GA 30078 478-453-7242<br />
Guydon, Linda MD* 770-507-0707 678-280-0202<br />
2296 Henderson Mill Rd Bibb County<br />
Ne<br />
Segall, Nathan MD* Rabinowitz, Paul MD*<br />
Ste 300<br />
980 Johnson Ferry Rd NE 3400 McClure Bridge Ahmed, Mirza*<br />
Atlanta, GA 30345 Ste 1080<br />
Road<br />
428 Poplar St<br />
770-491-9300 Atlanta, GA 30342 Bldg A / Suite A Ste A<br />
404-705-9170 Duluth, GA 30029 Macon, GA 31201<br />
McKean, Lawrence MD* 770-813-0254 478-741-6400<br />
17 Executive Park Dr Ne Sheerin, Kathleen MD*<br />
Ste 250<br />
2045 Peachtree Rd Ne Rabinowitz, Paul MD* Ahmed, Mirza*<br />
Atlanta, GA 30329 Ste 333<br />
656 Indian Trail Road 777 Hemlock St<br />
678-904-4390 Atlanta, GA 30309 Suite 208<br />
Macon, GA 31201<br />
404-351-5711 Lilburn, GA 30047 478-633-1100<br />
Silk, Howard MD* 770-925-2557<br />
2296 Henderson Mill Rd Stahlman, Jon*<br />
DeKalb County<br />
Ne<br />
1100 Lake Hearn Dr NE Schaffer, Kevin MD*<br />
Ste 300<br />
Ste 450 1780 Presidential Cir Allen, Tenecia*<br />
Atlanta, GA 30345 Atlanta, GA 30342 Ste 200 5910 Hillandale Dr<br />
770-491-9300<br />
404-252-7339 Snellville, GA 30078 Ste 350<br />
678-280-0202 Lithonia, GA 30058<br />
Fulton County Stahlman, Jon*<br />
678-578-8900<br />
3300 Old Milton Parkway Sheerin, Kathleen MD*<br />
Chacko, Thomas MD* STE 300 1990 Riverside Pkwy Baeten, Robert PA-C*<br />
1360 Upper Hembree Alpharetta, GA 30005 Lawrenceville, GA 30043 2801 DeKalb Medical<br />
Road 404-252-7339 770-995-1537 Pkwy<br />
Suite 201 Lithonia, GA 30058<br />
Roswell, GA 30076 Tanner, David MD* Tanner, David MD* 404-501-8110<br />
404-475-3361<br />
2045 Peachtree Rd Ne 4310 Johns Creek Pkwy<br />
Ste 333 Ste 130 Chandra, Sandeep*<br />
Holloway, Kelvin MD* Atlanta, GA 30309 Suwanee, GA 30024 1468 Montreal Rd<br />
75 Piedmont Avenue 404-351-5711 770-952-8612 Tucker, GA 30084<br />
Ste 700 770-638-1400<br />
Atlanta, GA 30303 Zora, John MD* Zora, John MD*<br />
404-756-1400<br />
401 S Main St 1990 Riverside Pkwy Chandra, Sandeep*<br />
Ste C-1 Lawrenceville, GA 30043 5910 Hillandale Dr<br />
Rabinowitz, Paul MD* Alpharetta, GA 30004 770-995-1537 Ste 350<br />
11660 Alpharetta Hwy 770-475-0807 Lithonia, GA 30058<br />
Suite 620 Cardiology (AOA) 678-578-8900<br />
Roswell, GA 30076 Gwinnett County<br />
770-740-9600<br />
DeKalb County Coralli, Richard*<br />
Chiang, Grace MD*<br />
2665 N Decatur Rd<br />
565 Old Norcross Rd Ramamurthy, Suresh* Ste 260<br />
Lawrenceville, GA 30045 1468 Montreal Rd Decatur, GA 30033<br />
770-995-5131 Tucker, GA 30084 404-297-9077<br />
770-638-1400<br />
Page 22<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Cardiology / Dotson, Sybil* Song, David* Forsyth County<br />
Cardiovascular 5900 Hillandale Dr 5910 Hillandale Dr Ste<br />
Ste F 350<br />
Singh, Narendra MD*<br />
Disease cont.<br />
Lithonia, GA 30058 Lithonia, GA 30058 1505 Northside Blvd<br />
770-322-6421 678-578-8900<br />
Suite 2500<br />
DeKalb County<br />
cont.<br />
Cumming, GA 30041<br />
Howard, Jeffrey* Srinivasan, Muthayyah* 678-679-6800<br />
Coralli, Richard* 2701 N Decatur Road 5225 Snapfinger Park Dr<br />
5900 Hillandale Dr Decatur, GA 30033 Ste 130<br />
Fulton County<br />
Ste F<br />
404-501-7925 Decatur, GA 30035<br />
Lithonia, GA 30058<br />
770-322-8881<br />
Arnold, William MD*<br />
770-322-6421<br />
Howard, Jeffrey*<br />
227 Mountain Cardiology<br />
2801 N Decatur Rd Stephan, Karen* Group<br />
Dorsey, Anthony* Ste 395<br />
2835 Brandywine Rd Suite 290<br />
1468 Montreal Rd Decatur, GA 30033 Ste 300<br />
Atlanta, GA 30342<br />
Tucker, GA 30084 404-223-1349 Atlanta, GA 30341 706-864-6136<br />
770-638-1400<br />
404-256-2593<br />
Kirschbaum, Paul*<br />
Arnold, William MD*<br />
Dorsey, Anthony* 2665 N Decatur Rd Suh, David*<br />
5665 Peachtree<br />
2675 N Decatur Rd Ste 260<br />
1468 Montreal Rd Dunwoody Rd NE<br />
Ste 200<br />
Decatur, GA 30033 Tucker, GA 30084 Ste 172<br />
Decatur, GA 30033 404-297-9077 770-638-1400<br />
Atlanta, GA 30342<br />
404-296-1256<br />
770-801-2364<br />
Kirschbaum, Paul* Suh, David*<br />
Dorsey, Anthony* 5900 Hillandale Dr 5910 Hillandale Drive Ste Balk, Michael MD*<br />
2701 N Decatur Rd Ste F 350<br />
5670 Peachtree<br />
Decatur, GA 30033 Lithonia, GA 30058 Lithonia, GA 30058 Dunwoody Rd Ne<br />
404-501-7925<br />
770-322-6421 678-578-8900<br />
Ste 880<br />
Atlanta, GA 30342<br />
Dorsey, Anthony* Nelson, Camille* Trivedi, Abhay* 404-256-2525<br />
2801 DeKalb Medical 2665 N Decatur Rd 1829 Lawrenceville<br />
Pkwy<br />
Ste 260<br />
Highway<br />
Bapat, Amol MD*<br />
Lithonia, GA 30058 Decatur, GA 30033 Decatur, GA 30033 1285 Upper Hembree Rd<br />
404-501-8000<br />
404-297-9077 404-982-0161<br />
Roswell, GA 30076<br />
770-343-8565<br />
Dorsey, Anthony* Nelson, Camille* Trivedi, Abhay*<br />
5910 Hillandale Dr 5900 Hillandale Dr 2675 N Decatur Rd Bapat, Amol*<br />
Ste 203<br />
Ste F Ste 200<br />
5885 Glenridge Dr<br />
Lithonia, GA 30058 Lithonia, GA 30058 Decatur, GA 30033 Suite 225<br />
770-981-1278<br />
770-322-6421 404-296-1256<br />
Atlanta, GA 30328<br />
404-847-0049<br />
Dorsey, Anthony* Sholas, Maurice* Trivedi, Abhay*<br />
5910 Hillandale Drive Ste 1405 Clifton Rd NE 5910 Hillandale Dr Bechler-Karsch, Abby*<br />
350<br />
Atlanta, GA 30322 Ste 203<br />
575 Professional Drive<br />
Lithonia, GA 30058 404-785-6000 Lithonia, GA 30058 Atlanta, GA 30384<br />
678-578-8900<br />
770-981-1278<br />
404-256-2593<br />
Singh, Narendra MD*<br />
Dotson, Sybil*<br />
1468 Montreal Rd Yan, Linda*<br />
Braunstein, Meryl MD*<br />
2665 N Decatur Rd Tucker, GA 30084 1468 Montreal Rd 1136 Cleveland Ave<br />
Ste 260<br />
770-638-1400 Tucker, GA 30084 Ste 208<br />
Decatur, GA 30033<br />
770-638-1400<br />
Atlanta, GA 30344<br />
404-297-9077<br />
Song, David* 404-761-9339<br />
1468 Montreal Rd Yan, Linda*<br />
Tucker, GA 30084 5910 Hillandale Dr<br />
770-638-1400 Ste 350<br />
Lithonia, GA 30058<br />
678-578-8900<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 23<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Cardiology / Egbe, Patrick* Malave, Hector MD* Oduwole, Adefisayo<br />
Cardiovascular 1136 Cleveland Ave 755 Mount Vernon Hwy MD*<br />
Disease<br />
Ste 208 Ne 75 Piedmont Avenue<br />
cont.<br />
Atlanta, GA 30344 Ste 530 Ste 700<br />
Fulton County cont. 404-761-9339 Atlanta, GA 30328 Atlanta, GA 30303<br />
404-252-7970 404-756-1400<br />
Brown, William MD* Friedland, Lance MD*<br />
5665 Peachtree 5665 Peachtree Marxer, Frank MD* Oduwole, Adefisayo<br />
Dunwoody Rd NE Dunwoody Rd Ne 5671 Peachtree MD*<br />
Atlanta, GA 30342 Atlanta, GA 30342 Dunwoody Rd Ne 80 Jesse Hill Jr Dr SE<br />
770-462-4721<br />
404-857-7844 Ste 320 Atlanta, GA 30303<br />
Atlanta, GA 30342 404-616-1415<br />
Brown, William MD* Hafeez, Nabeel MD* 404-255-9114<br />
5671 Peachtree 5670 Peachtree Paulk, Elijah MD*<br />
Dunwoody Rd NE Dunwoody Rd Ne Montgomery, Gary* 6330 Primrose Hill Ct<br />
Ste 320<br />
Ste 880 1001 Johnson Ferry Rd Ste 207<br />
Atlanta, GA 30342-5003 Atlanta, GA 30342 NE Alpharetta, GA 30005<br />
770-426-4721<br />
404-256-2525 Atlanta, GA 30342 770-452-0017<br />
404-785-5252<br />
Burkle, Jaime* Harris, Rachel MD*<br />
Prater, Stephen MD*<br />
5665 Peachtree 75 Piedmont Avenue Montgomery, Gary* 5665 Peachtree<br />
Dunwoody Rd NE Ste 700 1100 Lake Hearn Dr NE Dunwoody Rd NE<br />
Ste 172<br />
Atlanta, GA 30303 Ste 450 Ste 172<br />
Atlanta, GA 30342 404-756-1400 Atlanta, GA 30342 Atlanta, GA 30342<br />
770-801-2364<br />
404-252-7339 770-801-2364<br />
Harris, Rachel MD*<br />
Chen, Jack*<br />
80 Jesse Hill Jr Dr Mousa, Mousa MD* Rao, Gopal MD*<br />
5670 Peachtree Atlanta, GA 30303 1136 Cleveland Ave 1136 Cleveland Ave<br />
Dunwoody Rd Ne 404-616-5800 Ste 410 Ste 208<br />
Ste 880<br />
Atlanta, GA 30344 Atlanta, GA 30344<br />
Atlanta, GA 30342<br />
Incorvati, Dennis DO* 404-762-6140 404-761-9339<br />
404-256-2525<br />
5671 Peachtree<br />
Dunwoody Rd NE Narayani, Ramachanran Raval, Nirav MD*<br />
Clark, Jeffrey MD* Ste 320 MD* 5665 Peachtree<br />
5671 Peachtree Atlanta, GA 30342-5003 1861 Peeler Road Dunwoody Rd NE<br />
Dunwoody Rd Ne 770-426-4721 Ste 100 Ste 172<br />
Ste 320<br />
Atlanta, GA 30338 Atlanta, GA 30342<br />
Atlanta, GA 30342<br />
Kakkar, Aman MD* 770-730-5800 770-801-2364<br />
404-255-9114<br />
6325 W Johns Xing<br />
Bldg 1000 Narayani, Ramachanran Reddy, Kota MD*<br />
Cohen, Mark*<br />
Duluth, GA 30097 MD* 1861 Peeler Road<br />
5665 Peachtree 770-273-2188 6630 McGinnis Ferry Ste 100<br />
Dunwoody Rd NE<br />
Road Atlanta, GA 30338<br />
Ste 172<br />
Kopelman, Harry MD* Suite A 770-730-5800<br />
Atlanta, GA 30342<br />
5665 Peachtree Duluth, GA 30097<br />
770-801-2364<br />
Dunwoody Rd NE 678-957-9600<br />
Regis, Micaline PA*<br />
Ste 172<br />
275 Collier Road NW<br />
Egbe, Patrick*<br />
Atlanta, GA 30342 Narayani, Ramachanran Suite 300<br />
1046 Ridge Ave 770-801-2364 MD* Atlanta, GA 30309<br />
Atlanta, GA 30315<br />
9570 Nesbit Ferry Road 404-355-9815<br />
404-688-1350<br />
Lembo, Nicholas MD* Ste 100<br />
5665 Peachtree Alpharetta, GA 30022 Romm, Philip MD*<br />
Dunwoody Rd NE 770-645-1014<br />
5665 Peachtree<br />
Ste 172<br />
Dunwoody Rd Ne<br />
Atlanta, GA 30342 Atlanta, GA 30342<br />
770-801-2364 404-857-7844<br />
Page 24<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Cardiology / Trivedi, Abhay* Delaney, Sean MD* Heller, Louis MD*<br />
Cardiovascular 95 Collier Rd Nw Ste 631 Professional Dr 755 Walther Road<br />
Disease<br />
2075 Ste 360 Lawrenceville, GA 30045<br />
cont.<br />
Atlanta, GA 30309 Lawrenceville, GA 30046 770-962-0399<br />
Fulton County cont. 404-355-6562 770-962-4895<br />
Lesser, Laurence MD*<br />
Sholas, Maurice* Unterman, Marc MD* Dorsey, Anthony* 601A Professional DR<br />
1001 Johnson Ferry Rd 5665 Peachtree 1700 Tree Ln STE 370<br />
NE<br />
Dunwoody Rd Ne Ste 390 Lawrenceville, GA 30045<br />
Atlanta, GA 30342 Atlanta, GA 30342 Snellville, GA 30078 770-962-0399<br />
404-785-5252<br />
404-857-7844 770-972-0619<br />
Lesser, Laurence MD*<br />
Sholas, Maurice* Zimmerman, David MD* Friedland, Lance MD* 755 Walther Road<br />
11835 Alpharetta Hwy 5671 Peachtree 1700 Tree Ln Lawrenceville, GA 30045<br />
Roswell, GA 30076 Dunwoody Rd NE Ste 170 770-962-0399<br />
404-785-8470<br />
Ste 320 Snellville, GA 30078<br />
Atlanta, GA 30342-5003 770-979-1200<br />
Lipsitt, Michael*<br />
Sholas, Maurice* 770-426-4721<br />
755 Walther Rd<br />
35 Jesse Hill Jr Dr<br />
Friedland, Lance MD* Lawrenceville, GA 30045<br />
Atlanta, GA 30303 Gwinnett County 3540 Duluth Park Ln 770-962-0399<br />
404-785-9500<br />
Ste 200<br />
Barnhill, James MD* Duluth, GA 30096 Narayani, Ramachanran<br />
Sholas, Maurice* 1000 Medical Center Blvd 770-497-1413<br />
MD*<br />
5455 Meridian Mark Rd Lawrenceville, GA 30046<br />
6330 Primrose Hill Court<br />
Ste 200<br />
678-312-4616<br />
Friedland, Lance MD* Norcross, GA 30092<br />
Atlanta, GA 30342<br />
601A Professional DR 770-449-0990<br />
404-785-2239<br />
Barnhill, James MD* STE 370<br />
631 Professional Dr Lawrenceville, GA 30045 Porkert, Markus MD*<br />
Sholas, Maurice* Ste 360<br />
770-962-0399<br />
1000 Medical Center Blvd<br />
993F Johnson Ferry Rd Lawrenceville, GA 30046<br />
Lawrenceville, GA 30046<br />
Ne<br />
770-962-4895<br />
Friedland, Lance MD* 678-312-4616<br />
Ste 260<br />
755 Walther Road<br />
Atlanta, GA 30342<br />
Baykal, Demir MD* Lawrenceville, GA 30045 Porkert, Markus MD*<br />
404-785-3300<br />
1000 Medical Center Blvd 770-962-0399<br />
755 Walther Road<br />
Lawrenceville, GA 30046<br />
Lawrenceville, GA 30045<br />
Singh, Narendra MD* 678-312-4616<br />
Gangasani, Sreenivasula 770-962-0399<br />
5670 Peachtree<br />
MD*<br />
Dunwoody Rd Ne<br />
Baykal, Demir MD* 755 Walther Rd<br />
Proctor, Eugene MD*<br />
Ste 880<br />
631 Professional Dr Lawrenceville, GA 30045 755 Walther Rd<br />
Atlanta, GA 30342<br />
Ste 360 770-962-0399<br />
Lawrenceville, GA 30045<br />
404-256-2525<br />
Lawrenceville, GA 30046<br />
770-962-0399<br />
770-962-4895<br />
Hayat, Khalid MD*<br />
Stephan, Karen*<br />
1000 Medical Center Blvd Quinn, Corinne MD*<br />
Beach, Scott MD* Lawrenceville, GA 30046 600 Professional Dr<br />
5455 Meridian Marks Rd<br />
NE<br />
3350 Paddocks Pkwy 678-312-4616<br />
Ste 130<br />
Ste 530<br />
Johns Creek, GA 30024<br />
Lawrenceville, GA 30046<br />
Atlanta, GA 30342<br />
678-513-2273<br />
Hayat, Khalid MD* 678-225-5678<br />
404-256-2593<br />
631 Professional Dr<br />
Bergh, Mary MD* Ste 360<br />
Reddy, Kota MD*<br />
Toca, Forrest MD*<br />
1000 Medical Center Blvd Lawrenceville, GA 30046 6330 Prim Rose Hill Court<br />
999 Peachtree St NE<br />
Lawrenceville, GA 30046 770-962-4895<br />
Norcross, GA 30092<br />
678-312-4616<br />
770-903-0144<br />
Ste 850<br />
Atlanta, GA 30309<br />
Heller, Louis MD*<br />
Bergh, Mary MD*<br />
404-874-1788<br />
1000 Medical Center Blvd<br />
755 Walther Rd Lawrenceville, GA 30046<br />
Lawrenceville, GA 30045 678-312-4616<br />
770-962-0399<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 25<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Cardiology / Shonkoff, David MD* Rockdale County Fulton County<br />
Cardiovascular 755 Walther Road<br />
Lawrenceville, GA 30045 Dorsey, Anthony* Beaumont, Walter DC*<br />
Disease cont.<br />
770-962-0399<br />
1400 Wellbrook Cir Ne 923 Dill Avenue SW<br />
Ste 103 Atlanta, GA 30310<br />
Gwinnett County<br />
cont.<br />
Singh, Narendra MD* Conyers, GA 30012 404-753-3141<br />
4375 Johns Creek Pkwy 770-785-7112<br />
Reddy, Kota MD* Suite 350<br />
Brown, Johnny DC*<br />
6929 Jimmy Carter Blvd Suwanee, GA 30024 Trivedi, Abhay* 923 Dill Avenue SW<br />
Ste 100<br />
770-622-1622<br />
1400 Wellbrook Cir Ne Atlanta, GA 30310<br />
Norcross, GA 30071<br />
Ste 103 404-753-3141<br />
770-449-0990<br />
Trivedi, Abhay* Conyers, GA 30012<br />
1700 Tree Ln 770-785-7112<br />
Denmark, David DC*<br />
Romm, Philip MD* Ste 390<br />
923 Dill Avenue SW<br />
3540 Duluth Park Ln Snellville, GA 30078 Cardiovascular Atlanta, GA 30310<br />
Ste 200<br />
770-972-0619 Surgery<br />
404-753-3141<br />
Duluth, GA 30096<br />
Unterman, Marc MD* DeKalb County<br />
Jones, Corron DC*<br />
770-497-1413<br />
601A Professional DR<br />
923 Dill Avenue SW<br />
Romm, Philip MD* STE 370<br />
Allen, Tenecia* Atlanta, GA 30310<br />
601A Professional DR Lawrenceville, GA 30045 5910 Hillandale Dr 404-753-3141<br />
STE 370<br />
770-962-0399 Ste 350<br />
Lithonia, GA 30058<br />
Krolikowski, Edward<br />
Lawrenceville, GA 30045<br />
Unterman, Marc MD* 678-578-8900<br />
DC*<br />
770-962-0399<br />
755 Walther Road<br />
923 Dill Avenue SW<br />
Romm, Philip MD* Lawrenceville, GA 30045 Fulton County Atlanta, GA 30310<br />
755 Walther Road 770-962-0399<br />
404-753-3141<br />
Lawrenceville, GA 30045<br />
Ofili, Elizabeth MD*<br />
Videlefsky, Searle MD* 75 Piedmont Avenue Morrow, Shaunna MD*<br />
770-962-0399<br />
631 Professional Dr Ste 600<br />
923 Dill Avenue SW<br />
Sandler, Manfred MD* Ste 360<br />
Atlanta, GA 30303 Atlanta, GA 30310<br />
755 Walther Rd Lawrenceville, GA 30046 404-756-1410<br />
404-753-3141<br />
Lawrenceville, GA 30045 770-962-4895<br />
Sparlin, Samuel DC*<br />
770-962-0399 Certified Nurse<br />
Woodhouse, Sheila MD*<br />
923 Dill Avenue SW<br />
Midwife<br />
Sharma, Niraj MD* 755 Walther Rd<br />
Atlanta, GA 30310<br />
1000 Medical Center Blvd Lawrenceville, GA 30045<br />
404-753-3141<br />
Fulton County<br />
Lawrenceville, GA 30046 770-962-0399<br />
Vilardo, John DC*<br />
678-312-4616 Arp, Michelle*<br />
Houston County<br />
923 Dill Avenue SW<br />
340 Boulevard NE<br />
Sharma, Niraj MD* Atlanta, GA 30310<br />
Suite 103<br />
601A Professional DR Ahmed, Mirza*<br />
404-753-3141<br />
1118 Morningside Dr<br />
Atlanta, GA 30312<br />
STE 370<br />
Ste B<br />
404-223-2229 Weinberg, Judd DC*<br />
Lawrenceville, GA 30045<br />
Perry, GA 31069-4949<br />
1155 Hammond Drive<br />
770-962-0399<br />
478-988-8756<br />
Chiropractor Siute D 4285<br />
Sharma, Niraj MD* Atlanta, GA 30328-5320<br />
DeKalb County<br />
755 Walther Road Ahmed, Mirza*<br />
770-522-9800<br />
Lawrenceville, GA 30045 124 Hospital Dr Smith, Nailah DC*<br />
770-962-0399 Warner Robins, GA 31088 3636 Panola Rd<br />
478-922-4626 Ste B<br />
Sholas, Maurice*<br />
Ahmed, Mirza*<br />
Lithonia, GA 30038<br />
4850 Sugarloaf Pkwy<br />
707 North Houston Rd<br />
770-733-1381<br />
Ste 501<br />
Lawrenceville, GA 30044 Warner Robins, GA 31093<br />
404-785-8590<br />
478-741-6400<br />
Page 26<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Clinical Cardiac Schertzer, Marion* Schertzer, Marion* Mauldin, Damon*<br />
Electrophysiology 2675 N Decatur Rd 5555 Peachtree 1951 Clairmont Rd<br />
Ste 307 Dunwoody Rd Ne Ste 206 Decatur, GA 30033<br />
Gwinnett County Decatur, GA 30033 Atlanta, GA 30342 404-321-4600<br />
404-292-0393 404-851-1336<br />
Wilson, David MD*<br />
McAlvany, Joanne*<br />
1000 Medical Center Blvd Simon, Timothy* Simon, Timothy* 1951 Clairmont Rd<br />
Lawrenceville, GA 30045 2675 N Decatur Rd 550 Peachtree St Ne Ste Decatur, GA 30033<br />
770-339-2102<br />
Ste 307 1265 404-321-4600<br />
Decatur, GA 30033 Atlanta, GA 30308<br />
Wilson, David MD* 404-292-0393 404-522-7379<br />
Murad, Emma*<br />
601A Professional DR<br />
1951 Clairmont Rd<br />
STE 370<br />
Fayette County Gwinnett County Decatur, GA 30033<br />
Lawrenceville, GA 30045<br />
404-321-4600<br />
770-962-0399<br />
Choat, Dennis* Ambroze, Wayne*<br />
1260 Highway 54 W Ste 721 Wellness Way Spitlzer, Susan*<br />
Wilson, David MD* 100 Ste 200<br />
1951 Clairmont Rd<br />
755 Walther Road Fayetteville, GA 30214 Lawrenceville, GA 30045 Decatur, GA 30033<br />
Lawrenceville, GA 30045 404-292-0393 770-995-9528<br />
404-321-4600<br />
770-962-0399<br />
Fulton County Armstrong, David* Stonecipher, Marcus*<br />
Colon and Rectal<br />
721 Wellness Way 1951 Clairmont Rd<br />
Ambroze, Wayne* Ste 200<br />
Decatur, GA 30033<br />
Surgery 5555 Peachtree Lawrenceville, GA 30045 404-321-4600<br />
DeKalb County<br />
Dunwoody Rd Ne Ste 206 770-995-9528<br />
Atlanta, GA 30342<br />
Fulton County<br />
Ambroze, Wayne* 404-851-1336<br />
Pennington, E.*<br />
3905 Johns Creek Ct Cox, Gregory*<br />
2675 N Decatur Rd<br />
Choat, Dennis* Suite 200<br />
5455 Meridian Mark Rd<br />
Ste 307<br />
550 Peachtree St Ne Ste Suwanee, GA 30024 Ste 200<br />
Decatur, GA 30033<br />
1265 678-954-8538<br />
Atlanta, GA 30342<br />
404-292-0393<br />
Atlanta, GA 30308<br />
404-785-2239<br />
Armstrong, David* 404-522-7379<br />
Venkatesh, Kota*<br />
3905 Johns Creek Court Cox, Gregory*<br />
2675 N Decatur Rd<br />
Mayer, Raoul MD* Ste 200<br />
5505 Peachtree<br />
Ste 307<br />
5667 Peachtree Suwanee, GA 30024 Dunwoody Rd<br />
Decatur, GA 30033<br />
Dunwoody Rd Ne 678-954-8538<br />
Ste 412<br />
404-292-0393<br />
Ste 330<br />
Atlanta, GA 30342<br />
Mayer, Raoul MD* Atlanta, GA 30342 Critical Care 404-459-9177<br />
2675 N Decatur Rd 404-252-5669<br />
Fulton County Humphrey, Florence<br />
Ste 614<br />
Orangio, Guy*<br />
MD*<br />
Decatur, GA 30033<br />
5555 Peachtree Flenaugh, Eric MD* 285 Boulevard NE<br />
404-294-9900<br />
Dunwoody Rd Ne Ste 206 80 Jesse Hill Jr Drive Ste 430<br />
Mayer, Raoul MD* Atlanta, GA 30342 Atlanta, GA 30303 Atlanta, GA 30312<br />
5900 Hillandale Dr 404-851-1336 404-756-5271<br />
404-659-1795<br />
Ste 245<br />
Pennington, E. MD* Dermatology Levin, Jay MD*<br />
Lithonia, GA 30058<br />
5555 Peachtree<br />
5667 Peachtree<br />
404-294-9900<br />
Dunwoody Rd Ne Ste 206 DeKalb County Dunwoody Rd Ne<br />
Orangio, Guy*<br />
Atlanta, GA 30342<br />
Ste 200<br />
2675 N Decatur Rd 404-851-1336<br />
Braza, Thomas* Atlanta, GA 30342<br />
Ste 307<br />
1951 Clairmont Rd 404-252-4110<br />
Decatur, GA 30033<br />
Decatur, GA 30033<br />
404-292-0393<br />
404-321-4600<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 27<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Dermatology cont. Mauldin, Damon* Diagnostic Falcon, Hugo MD*<br />
5635 Peachtree Pkwy Radiology<br />
2774 N Decatur Rd<br />
Fulton County cont. Ste 270 Ste B<br />
Norcross, GA 30092 DeKalb County Decatur, GA 30033<br />
Timani Charkawi, 678-728-1500 404-299-2887<br />
Shereen MD*<br />
Baptiste, Philip MD*<br />
6300 Hospital Parkway McAlvany, Joanne* 2774 N Decatur Rd Falcon, Hugo MD*<br />
Ste 100 3890 Johns Creek Pkwy Decatur, GA 30033 2774 N Decatur Rd<br />
Duluth, GA 30097 Ste 320 404-292-2277<br />
Decatur, GA 30033<br />
770-771-6591 Suwanee, GA 30024 404-292-2277<br />
770-622-4412<br />
Belcher, Kelvin*<br />
Gwinnett County<br />
2675 N Decatur Rd Ste Fleming, Jacob*<br />
McAlvany, Joanne* 310<br />
5671 Peachtree<br />
Bonaccorsi, Paola MD* 5635 Peachtree Pkwy Decatur, GA 30033 Dunwoody Rd Ne<br />
4825 Johns Creek Ste 270 404-564-5400<br />
Atlanta, GA 30319<br />
Parkway Norcross, GA 30092 404-256-4619<br />
Suite A<br />
678-728-1500<br />
Belcher, Kelvin*<br />
Suwanee, GA 30024<br />
2701 N Decatur Rd Gilbert, Stewart*<br />
770-622-4412 Spitlzer, Susan* Decatur, GA 30033 2774 N Decatur Rd<br />
3890 Johns Creek Pkwy 404-501-1000<br />
Decatur, GA 30033<br />
Braza, Thomas* Ste 320 404-292-2277<br />
3890 Johns Creek Pkwy Suwanee, GA 30024 Belcher, Kelvin*<br />
Ste 320<br />
770-622-4412<br />
5900 Hillandale Dr Grossman, Clifford*<br />
Suwanee, GA 30024<br />
Lithonia, GA 30058 2774 N Decatur Rd<br />
770-622-4412 Stonecipher, Marcus* 404-501-8299<br />
Decatur, GA 30033<br />
3890 Johns Creek Pkwy 404-292-2277<br />
Braza, Thomas* Ste 320<br />
Chaliff, Michael MD*<br />
4825 Johns Creek Suwanee, GA 30024 2774 N Decatur Rd Hendrix, Vernon MD*<br />
Parkway<br />
770-622-4412<br />
Decatur, GA 30033 1150 Hammond Dr<br />
Suite A 404-292-2277<br />
Building D Suite 4100<br />
Suwanee, GA 30024 Stonecipher, Marcus* Atlanta, GA 30329<br />
770-622-4412 5635 Peachtree Pkwy Coffsky, Jay*<br />
770-399-0434<br />
Ste 270<br />
1190 W Druid Hills Rd NE<br />
Braza, Thomas* Norcross, GA 30092 Ste T-75<br />
Hendrix, Vernon MD*<br />
5635 Peachtree Pkwy 678-728-1500<br />
Atlanta, GA 30329 2754 North Decatur Rd<br />
Ste 270 404-501-7120<br />
Suite 104<br />
Norcross, GA 30092 Dermatopathology<br />
Decatur, GA 30033<br />
678-728-1500 Coffsky, Jay*<br />
404-292-2277<br />
Fulton County 2675 N Decatur Rd Ste<br />
Hafeez, Abdul*<br />
310<br />
Hendrix, Vernon MD*<br />
4285 Johns Creek Barber, Julie MD* Decatur, GA 30033 2774 N Decatur Rd<br />
Parkway 6095 Barfield Rd NE 404-564-5400<br />
Decatur, GA 30033<br />
Ste A Ste 200<br />
404-292-2277<br />
Suwanee, GA 30024 Atlanta, GA 30328 Coffsky, Jay*<br />
770-622-4412 404-851-1766<br />
2701 N Decatur Rd Hendrix, Vernon MD*<br />
Decatur, GA 30033 2774 N Decatur Rd<br />
Hafeez, Abdul* Finan, Marian MD* 404-501-1000<br />
Ste B<br />
5635 Peachtree Pkwy 6095 Barfield Rd<br />
Decatur, GA 30033<br />
Ste 270 Ste 200<br />
Coffsky, Jay*<br />
404-299-2887<br />
Norcross, GA 30092 Atlanta, GA 30328 5900 Hillandale Dr<br />
678-728-1500 404-252-2420<br />
Lithonia, GA 30058 Hixson, Gordon*<br />
404-501-8299<br />
1190 W Druid Hills Rd NE<br />
Mauldin, Damon* Ste T-75<br />
3890 Johns Creek Pkwy Erickson, Eric* Atlanta, GA 30329<br />
Ste 320 2701 N Decatur Rd 404-501-7120<br />
Suwanee, GA 30024<br />
Decatur, GA 30033<br />
770-622-4412<br />
404-501-1000<br />
Page 28<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Diagnostic Laskey, Gary* Schwartz, Terry* Baptiste, Philip MD*<br />
Radiology cont. 2675 N Decatur Rd Ste 2545 Lawrenceville Hwy 1100 Lake Hearn Dr<br />
310 Ste 200 Ste 320<br />
DeKalb County Decatur, GA 30033 Decatur, GA 30033 Atlanta, GA 30342<br />
cont. 404-564-5400 770-934-7876 404-257-1858<br />
Hixson, Gordon* Laskey, Gary* Schwartz, Terry* Baptiste, Philip MD*<br />
2675 N Decatur Rd Ste 2701 N Decatur Rd 809 Main St 303 Parkway Dr NE<br />
310 Decatur, GA 30033 Stone Mountain, GA Atlanta, GA 30312<br />
Decatur, GA 30033 404-501-1000 30083 404-265-4565<br />
404-564-5400 770-469-4131<br />
Laskey, Gary*<br />
Baptiste, Philip MD*<br />
Hixson, Gordon* 5900 Hillandale Dr Seely, Melissa* 993 Johnson Ferry Rd NE<br />
2701 N Decatur Rd Lithonia, GA 30058 2675 North Decatur Rd Atlanta, GA 30342<br />
Decatur, GA 30033 404-501-8299 Ste 310 404-303-0707<br />
404-501-1000 Decatur, GA 30033<br />
Mulick, Arthur* 404-501-5200<br />
Barlow, Richard*<br />
Hixson, Gordon* 2774 N Decatur Rd 1000 Johnson Ferry Rd<br />
5900 Hillandale Dr Decatur, GA 30033 Stieber, Andrei* NE<br />
Lithonia, GA 30058 404-292-2277 1364 Clifton Rd NE - Atlanta, GA 30342<br />
404-501-8299 Anesthesiology 404-851-6330<br />
O’Brien, Sean MD* Atlanta, GA 30322<br />
Humphrey, Lizabeth* 2774 N Decatur Rd 404-778-3900<br />
Barlow, Richard*<br />
2774 N Decatur Rd Decatur, GA 30033 3400 Old Milton Pkwy<br />
Decatur, GA 30033 404-292-2277 Stieber, Andrei* Ste 145<br />
404-292-2277 1365 Clifton Rd NE Alpharetta, GA 30005<br />
O’Brien, Sean MD* Bldg A 770-667-4000<br />
Joshi, Ajay MD* 2774 N Decatur Rd Atlanta, GA 30322-1013<br />
2701 N Decatur Rd Ste B 404-778-2020<br />
Barlow, Richard*<br />
Decatur, GA 30033 Decatur, GA 30033 5445 Meridian Marks Rd<br />
404-501-1000 404-299-2887 Stieber, Andrei* NE<br />
2665 N Decatur Rd Ste 450<br />
Joshi, Ajay MD* Price, Robert* Ste 730 Atlanta, GA 30342<br />
450 North Candler Street 2774 N Decatur Rd Decatur, GA 30033 404-459-1875<br />
Decatur, GA 30030 Ste B 404-564-1958<br />
404-377-0221 Decatur, GA 30033 Barlow, Richard*<br />
404-299-2887 Fulton County 980 Johnson Ferry Rd NE<br />
Kaila, Pramod* Ste 300<br />
2675 N Decatur Rd Ste Reid, John* Amerson, James MD* Atlanta, GA 30342<br />
310 2701 N Decatur Rd 1000 Johnson Ferry Rd 404-851-8381<br />
Decatur, GA 30033 Decatur, GA 30033 NE<br />
404-564-5400 404-501-1000 Atlanta, GA 30342 Beland, Jason*<br />
404-851-6330<br />
5565 Peachtree<br />
Kaila, Pramod* Reid, John* Dunwoody Rd NE<br />
2701 N Decatur Rd 5900 Hillandale Dr Amerson, James MD* Atlanta, GA 30342<br />
Decatur, GA 30033 Lithonia, GA 30058 5445 Meridian Marks Rd 404-256-5193<br />
404-501-1000 404-501-8299 NE<br />
Ste 450<br />
Bell, Meredith*<br />
Kaila, Pramod* Schechter, Ann* Atlanta, GA 30342 3400 Old Milton Pkwy<br />
5900 Hillandale Dr 2015 Upper Gate Dr NE 404-459-1875<br />
Ste 145<br />
Lithonia, GA 30058 Atlanta, GA 30322 Alpharetta, GA 30005<br />
404-501-8299 404-778-2400 Amerson, James MD* 770-667-4000<br />
980 Johnson Ferry Rd NE<br />
Ste 300<br />
Atlanta, GA 30342<br />
404-851-8381<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 29<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Diagnostic Falcon, Hugo MD* Figueroa, Amy* Hanes, Timothy*<br />
Radiology cont. 1150 Hammond Dr NE 980 Johnson Ferry Rd NE 1100 Johnson Ferry Rd<br />
Atlanta, GA 30328 Ste 300 Ne Ste 245<br />
Fulton County cont. 770-399-0434 Atlanta, GA 30342 Atlanta, GA 30342<br />
404-851-8381 404-256-5193<br />
Bell, Meredith* Falcon, Hugo MD*<br />
980 Johnson Ferry Rd NE 303 Parkway Dr NE Fleming, Jacob* Hanna, Soheil*<br />
Ste 300<br />
Atlanta, GA 30312 1100 Johnson Ferry Rd 1000 Johnson Ferry Rd<br />
Atlanta, GA 30342 404-265-4565 Ne Ste 245 NE<br />
404-851-8381<br />
Atlanta, GA 30342 Atlanta, GA 30342<br />
Falcon, Hugo MD* 404-256-5193 404-851-6330<br />
Chaliff, Michael MD* 800 Johnson Ferry Rd NE<br />
1100 Lake Hearn Drive Atlanta, GA 30342 Fleming, Jacob* Hanna, Soheil*<br />
Ste 150<br />
404-250-1829 5665 Peachtree 3400 Old Milton Pkwy<br />
Atlanta, GA 30342<br />
Dunwoody Rd Ste 145<br />
404-255-5512<br />
Falcon, Hugo MD* Atlanta, GA 30342 Alpharetta, GA 30005<br />
993 Johnson Ferry Rd NE 404-256-5193 770-667-4000<br />
Chaliff, Michael MD* Atlanta, GA 30342<br />
303 Parkway Dr NE 404-303-0707 Foreman, Charles* Hanna, Soheil*<br />
Atlanta, GA 30312<br />
35 Collier Rd Nw Ste 635 5445 Meridian Marks Rd<br />
404-265-4565<br />
Feiner, Clifford MD* Atlanta, GA 30309 NE<br />
1000 Johnson Ferry Rd 404-367-3014 Ste 450<br />
Chaliff, Michael MD* NE<br />
Atlanta, GA 30342<br />
993 Johnson Ferry Rd NE Atlanta, GA 30342 Fuller, Thomas MD* 404-459-1875<br />
Atlanta, GA 30342 404-851-6330 303 Parkway Dr NE<br />
404-303-0707<br />
Atlanta, GA 30312 Hanna, Soheil*<br />
Feiner, Clifford MD* 404-265-4565 980 Johnson Ferry Rd NE<br />
Datoc, Patrick* 5445 Meridian Marks Rd<br />
Ste 300<br />
1000 Johnson Ferry Rd NE<br />
Fulp, Charles*<br />
Atlanta, GA 30342<br />
NE Ste 450<br />
5565 Peachtree 404-851-8381<br />
Atlanta, GA 30342 Atlanta, GA 30342 Dunwoody Rd NE<br />
404-851-6330<br />
404-459-1875 Atlanta, GA 30342 Hayes, Laura*<br />
404-256-5193 1001 Johnson Ferry Rd<br />
Datoc, Patrick* Feiner, Clifford MD*<br />
Ne<br />
3400 Old Milton Pkwy 980 Johnson Ferry Rd NE Fulp, Charles*<br />
Atlanta, GA 30342<br />
Ste 145 Ste 300<br />
5671 Peachtree 404-785-5252<br />
Alpharetta, GA 30005 Atlanta, GA 30342 Dunwoody Rd Ne<br />
770-667-4000<br />
404-851-8381 Ste 100 Hayes, Laura*<br />
Atlanta, GA 30342 3155 N Point Pkwy<br />
Datoc, Patrick* Figueroa, Amy* 404-256-4619 Bldg A<br />
5445 Meridian Marks Rd 1000 Johnson Ferry Rd<br />
Alpharetta, GA 30005<br />
NE NE<br />
Gilbert, Stewart* 404-785-8570<br />
Ste 450<br />
Atlanta, GA 30342 303 Parkway Dr NE<br />
Atlanta, GA 30342 404-851-6330 Atlanta, GA 30312 Hendrix, Vernon MD*<br />
404-459-1875<br />
404-265-4565 1150 Hammond Dr NE<br />
Figueroa, Amy*<br />
Ste B2140<br />
Datoc, Patrick* 3400 Old Milton Pkwy Grattan Smith, John* Atlanta, GA 30328<br />
980 Johnson Ferry Rd NE Ste 145<br />
1001 Johnson Ferry Rd 404-459-8440<br />
Ste 300<br />
Alpharetta, GA 30005 Ne<br />
Atlanta, GA 30342 770-667-4000 Atlanta, GA 30342 Hendrix, Vernon MD*<br />
404-851-8381<br />
404-785-5252 303 Parkway Dr NE<br />
Figueroa, Amy* Atlanta, GA 30312<br />
Durrett, Donald* 5445 Meridian Marks Rd Grattan Smith, John* 404-265-4565<br />
1170 Cleveland Ave NE<br />
3155 N Point Pkwy<br />
Atlanta, GA 30344 Ste 450<br />
BLDG A, STE100<br />
404-305-3500<br />
Atlanta, GA 30342 Alpharetta, GA 30005<br />
404-459-1875 404-785-8570<br />
Page 30<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Diagnostic Krebs, Henry* McClees, Rita* Meli, Richard MD*<br />
Radiology cont. 5671 Peachtree 5671 Peachtree 980 Johnson Ferry Rd NE<br />
Dunwoody Rd Ne Dunwoody Rd Ne Ste 300<br />
Fulton County cont. Ste 100 Ste 100 Atlanta, GA 30342<br />
Atlanta, GA 30342 Atlanta, GA 30342 404-851-8381<br />
Hendrix, Vernon MD* 404-256-4619 404-256-4619<br />
993 Johnson Ferry Rd NE<br />
Moss, Steven*<br />
Atlanta, GA 30342 Lee, Eugene* McIntosh, Thomas* 1000 Johnson Ferry Rd<br />
404-303-0707<br />
1000 Johnson Ferry Rd 1000 Johnson Ferry Rd NE<br />
NE NE Atlanta, GA 30342<br />
Humphrey, Lizabeth* Atlanta, GA 30342 Atlanta, GA 30342 404-851-6330<br />
303 Parkway Dr NE 404-851-6330 404-851-6330<br />
Atlanta, GA 30312<br />
Moss, Steven*<br />
404-265-4565<br />
Levy, Jason MD* McIntosh, Thomas* 3400 Old Milton Pkwy<br />
1000 Johnson Ferry Rd 3400 Old Milton Pkwy Ste 145<br />
Jeffries, Barry* NE Ste 145 Alpharetta, GA 30005<br />
303 Parkway Dr Ne Atlanta, GA 30342 Alpharetta, GA 30005 770-667-4000<br />
Atlanta, GA 30312 404-851-6330 770-667-4000<br />
404-459-8440<br />
Moss, Steven*<br />
Levy, Jason MD* McIntosh, Thomas* 5445 Meridian Marks Rd<br />
Johnson, Alan MD* 3400 Old Milton Pkwy 5445 Meridian Marks Rd NE<br />
303 Parkway Drive Ste 145 NE Ste 450<br />
Atlanta, GA 30312 Alpharetta, GA 30005 Ste 450 Atlanta, GA 30342<br />
404-265-4565 770-667-4000 Atlanta, GA 30342 404-459-1875<br />
404-459-1875<br />
Kallanos, George* Levy, Jason MD* Moss, Steven*<br />
5565 Peachtree 5445 Meridian Marks Rd McIntosh, Thomas* 980 Johnson Ferry Rd NE<br />
Dunwoody Rd NE NE 980 Johnson Ferry Rd NE Ste 300<br />
Atlanta, GA 30342 Ste 450 Ste 300 Atlanta, GA 30342<br />
404-256-5193 Atlanta, GA 30342 Atlanta, GA 30342 404-851-8381<br />
404-459-1875 404-851-8381<br />
Kallanos, George*<br />
Mulick, Arthur*<br />
5671 Peachtree Levy, Jason MD* Meli, Richard MD* 303 Parkway Dr NE<br />
Dunwoody Rd Ne 980 Johnson Ferry Rd NE 1000 Johnson Ferry Rd Atlanta, GA 30312<br />
Ste 100 Ste 300 NE 404-265-4565<br />
Atlanta, GA 30342 Atlanta, GA 30342 Atlanta, GA 30342<br />
404-256-4619 404-851-8381 404-851-6330<br />
Mulligan, Susan*<br />
1100 Johnson Ferry Rd<br />
Kallman, Douglas MD* Little, Stephen* Meli, Richard MD* Ne Ste 245<br />
1000 Johnson Ferry Rd 1001 Johnson Ferry Rd 3400 Old Milton Pkwy Atlanta, GA 30342<br />
NE Ne Ste 145 404-256-5193<br />
Atlanta, GA 30342 Atlanta, GA 30342 Alpharetta, GA 30005<br />
404-851-6330 404-785-5252 770-667-4000<br />
Neish, Ariane*<br />
1001 Johnson Ferry Rd<br />
Kallman, Douglas MD* Little, Stephen* Meli, Richard MD* Ne<br />
5445 Meridian Marks Rd 3155 N Point Pkwy 5445 Meridian Marks Rd Atlanta, GA 30342<br />
NE BLDG A, STE100 Ne 404-785-5252<br />
Ste 450 Alpharetta, GA 30005 Atlanta, GA 30342<br />
Atlanta, GA 30342 404-785-8570 404-459-1875<br />
Neish, Ariane*<br />
404-459-1875<br />
3155 N Point Pkwy<br />
McClees, Rita* Meli, Richard MD* Bldg A<br />
Krebs, Henry* 5565 Peachtree 80 Jesse Hill Jr Dr Se Alpharetta, GA 30005<br />
5565 Peachtree Dunwoody Rd NE Atlanta, GA 30303 404-785-8570<br />
Dunwoody Rd NE Atlanta, GA 30342 404-881-3020<br />
Atlanta, GA 30342 404-256-5193<br />
404-256-5193<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 31<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
Diagnostic<br />
Radiology cont.<br />
Fulton County cont.<br />
Nicol, Mark*<br />
1000 Johnson Ferry Rd<br />
NE<br />
Atlanta, GA 30342<br />
404-851-6330<br />
Nicol, Mark*<br />
3400 Old Milton Pkwy<br />
Ste 145<br />
Alpharetta, GA 30005<br />
770-667-4000<br />
Nicol, Mark*<br />
5445 Meridian Marks Rd<br />
NE<br />
Ste 450<br />
Atlanta, GA 30342<br />
404-459-1875<br />
Nicol, Mark*<br />
980 Johnson Ferry Rd NE<br />
Ste 300<br />
Atlanta, GA 30342<br />
404-851-8381<br />
Nixon, Kathleen MD*<br />
1000 Johnson Ferry Rd<br />
NE<br />
Atlanta, GA 30342<br />
404-851-6330<br />
Nixon, Kathleen MD*<br />
3400 Old Milton Pkwy<br />
Ste 145<br />
Alpharetta, GA 30005<br />
770-667-4000<br />
Nixon, Kathleen MD*<br />
5445 Meridian Marks Rd<br />
NE<br />
Ste 450<br />
Atlanta, GA 30342<br />
404-459-1875<br />
Nixon, Kathleen MD*<br />
980 Johnson Ferry Rd NE<br />
Ste 300<br />
Atlanta, GA 30342<br />
404-851-8381<br />
List of Plan <strong>Provider</strong>s<br />
Norris, Shannon* Ostrow, Todd* Schechter, Ann*<br />
1000 Johnson Ferry Rd 980 Johnson Ferry Rd NE 3155 N Point Pkwy<br />
NE Ste 300 Bldg A<br />
Atlanta, GA 30342 Atlanta, GA 30342 Alpharetta, GA 30005<br />
404-851-6330 404-851-8381 404-785-8570<br />
Norris, Shannon* Palasis, Susan* Schwartz, Terry*<br />
3400 Old Milton Pkwy 1001 Johnson Ferry Rd 1150 Hammond Dr NE<br />
Ste 145 Ne Ste B2140<br />
Alpharetta, GA 30005 Atlanta, GA 30342 Atlanta, GA 30328<br />
770-667-4000 404-785-5252 404-459-8440<br />
Norris, Shannon* Palasis, Susan* Schwartzberg, Daniel*<br />
5445 Meridian Marks Rd 3155 N Point Pkwy 1252 North Ave NE<br />
Ne Bldg A Atlanta, GA 30307<br />
Atlanta, GA 30342 Alpharetta, GA 30005 404-522-5828<br />
404-459-1875 404-785-8570<br />
Schwartzberg, Daniel*<br />
Norris, Shannon* Price, Robert* 303 Parkway Dr NE<br />
980 Johnson Ferry Rd NE 303 Parkway Dr Atlanta, GA 30312<br />
Ste 300 Atlanta, GA 30312 404-265-4565<br />
Atlanta, GA 30342 404-265-4565<br />
404-851-8381<br />
Schwartzberg, Daniel*<br />
Price, Robert*<br />
303 Parkway Dr Ne<br />
O’Brien, Sean MD* 993 Johnson Ferry Rd NE Atlanta, GA 30312<br />
1150 Hammond Dr NE Atlanta, GA 30342 404-459-8440<br />
Ste B2140 404-303-0707<br />
Atlanta, GA 30328<br />
Seely, Melissa*<br />
404-459-8440<br />
Rim, Sharon MD* 5565 Peachtree<br />
1000 Johnson Ferry Rd Dunwoody Rd NE<br />
O’Brien, Sean MD* NE Atlanta, GA 30342<br />
303 Parkway Dr NE Atlanta, GA 30342 404-256-5193<br />
Atlanta, GA 30312 404-851-6330<br />
404-265-4565<br />
Share, Jane*<br />
Rim, Sharon MD* 1001 Johnson Ferry Rd<br />
Ostrow, Todd* 3400 Old Milton Pkwy Ne<br />
1000 Johnson Ferry Rd Ste 145 Atlanta, GA 30342<br />
NE Alpharetta, GA 30005 404-785-5252<br />
Atlanta, GA 30342 770-667-4000<br />
404-851-6330<br />
Share, Jane*<br />
Rim, Sharon MD* 3155 N Point Pkwy<br />
Ostrow, Todd* 5445 Meridian Marks Rd Bldg A<br />
3400 Old Milton Pkwy Ne Alpharetta, GA 30005<br />
Ste 145 Atlanta, GA 30342 404-785-8570<br />
Alpharetta, GA 30005 404-459-1875<br />
770-667-4000<br />
Simpson, Nicole*<br />
Rim, Sharon MD* 1170 Cleveland Ave<br />
Ostrow, Todd* 980 Johnson Ferry Rd NE Atlanta, GA 30344<br />
5445 Meridian Marks Rd Ste 300 404-305-3500<br />
NE Atlanta, GA 30342<br />
Ste 450 404-851-8381<br />
Spencer, Kimberly MD*<br />
Atlanta, GA 30342<br />
303 Parkway Dr NE<br />
404-459-1875<br />
Schechter, Ann* Atlanta, GA 30312<br />
1001 Johnson Ferry Rd 404-265-4565<br />
Ne<br />
Atlanta, GA 30342<br />
404-785-5252<br />
Page 32<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Diagnostic Trinh, Thai* Tyrrell, Robert* Weaver, Carolyn*<br />
Radiology cont. 1001 Johnson Ferry RD 980 Johnson Ferry Rd NE 1000 Johnson Ferry Rd<br />
Atlanta, GA 30342-1605 Ste 300 NE<br />
Fulton County cont. 404-785-5252 Atlanta, GA 30342 Atlanta, GA 30342<br />
404-851-8381 404-851-6330<br />
Steele, J*<br />
Trinh, Thai*<br />
5565 Peachtree 3155 N Point Pkwy Udoff, Eric MD* Weaver, Carolyn*<br />
Dunwoody Rd NE Bldg A 303 Parkway Dr NE 3400 Old Milton Pkwy<br />
Atlanta, GA 30342 Alpharetta, GA 30005 Atlanta, GA 30312 Alpharetta, GA 30005<br />
404-256-5193<br />
404-785-8570 404-265-4565 770-667-4000<br />
Steele, J*<br />
Tyber, Andy*<br />
Umpierrez, Monica* Gwinnett County<br />
5671 Peachtree 1000 Johnson Ferry Rd 1100 Johnson Ferry Rd<br />
Dunwoody Rd Ne NE Ne Ste 245<br />
Amerson, James MD*<br />
Ste 100<br />
Atlanta, GA 30342 Atlanta, GA 30342 3890 Johns Creek Pkwy<br />
Atlanta, GA 30342 404-851-6330 404-256-5193<br />
Ste 100<br />
404-256-4619<br />
Suwanee, GA 30024<br />
Tyber, Andy* Umpierrez, Monica* 678-475-6595<br />
Stiles, Richard* 3400 Old Milton Pkwy 5565 Peachtree<br />
5565 Peachtree Ste 145<br />
Dunwoody Rd NE Anderson, David*<br />
Dunwoody Rd NE Alpharetta, GA 30005 Atlanta, GA 30342 1000 Medical Center Blvd<br />
Atlanta, GA 30342 770-667-4000 404-256-5193<br />
Lawrenceville, GA 30045<br />
404-256-5193<br />
678-312-4440<br />
Tyber, Andy*<br />
Vassiliades, Venetia<br />
Stiles, Richard* 5445 Meridian Marks Rd MD*<br />
Anderson, David*<br />
5671 Peachtree NE<br />
1000 Johnson Ferry Rd 2078 Teron Trace<br />
Dunwoody Rd Ne Ste 450<br />
NE<br />
Dacula, GA 30019<br />
Ste 100<br />
Atlanta, GA 30342 Atlanta, GA 30342 678-312-4440<br />
Atlanta, GA 30342 404-459-1875 404-851-6330<br />
404-256-4619<br />
Anderson, David*<br />
Tyber, Andy*<br />
Vassiliades, Venetia 3215 Mcclure Bridge Rd<br />
Tippins, Russell MD* 980 Johnson Ferry Rd NE MD*<br />
Duluth, GA 30096<br />
1000 Johnson Ferry Rd Ste 300<br />
3400 Old Milton Pkwy 678-312-6000<br />
NE<br />
Atlanta, GA 30342 Ste 145<br />
Atlanta, GA 30342 404-851-8381 Alpharetta, GA 30005<br />
Anderson, David*<br />
404-851-6330<br />
770-667-4000<br />
3620 Howell Ferry Rd<br />
Tyrrell, Robert*<br />
Duluth, GA 30096<br />
Tippins, Russell MD* 1000 Johnson Ferry Rd Vassiliades, Venetia 678-312-6800<br />
3400 Old Milton Pkwy NE<br />
MD*<br />
Ste 145<br />
Atlanta, GA 30342 5445 Meridian Marks Rd<br />
Anderson, David*<br />
404-851-6330 Ne<br />
550 Medical Center Blvd<br />
Alpharetta, GA 30005<br />
770-667-4000<br />
Atlanta, GA 30342<br />
Lawrenceville, GA 30045<br />
Tyrrell, Robert* 404-459-1875<br />
678-442-6001<br />
Tippins, Russell MD* 3400 Old Milton Pkwy<br />
Ste 145<br />
Vassiliades, Venetia<br />
Anderson, David*<br />
5445 Meridian Marks Rd<br />
NE<br />
Alpharetta, GA 30005 MD*<br />
575 Professional Dr<br />
Ste 450<br />
770-667-4000 980 Johnson Ferry Rd NE<br />
Lawrenceville, GA 30045<br />
Atlanta, GA 30342<br />
Ste 300<br />
678-312-4440<br />
404-459-1875 Tyrrell, Robert* Atlanta, GA 30342<br />
5445 Meridian Marks Rd<br />
Barlow, Richard*<br />
404-851-8381<br />
Tippins, Russell MD* NE<br />
758 Old Norcross Rd<br />
980 Johnson Ferry Rd NE Ste 450<br />
Vemuri, Sreekanth*<br />
Ste 110<br />
Ste 300<br />
Atlanta, GA 30342 980 Johnson Ferry Rd NE<br />
Lawrenceville, GA 30043<br />
Atlanta, GA 30342 404-459-1875 Ste 300<br />
678-985-7180<br />
404-851-8381<br />
Atlanta, GA 30342<br />
404-851-8381<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 33<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Diagnostic Hanna, Soheil* McIntosh, Thomas* Nixon, Kathleen MD*<br />
Radiology cont. 3890 Johns Creek Pkwy 758 Old Norcross Rd 758 Old Norcross Rd<br />
Ste 100 Ste 110 Ste 110<br />
Gwinnett County Suwanee, GA 30024 Lawrenceville, GA 30043 Lawrenceville, GA 30043<br />
cont. 678-475-6595 678-985-7180 678-985-7180<br />
Bell, Meredith* Hanna, Soheil* Meli, Richard MD* Norris, Shannon*<br />
601 Professional Drive 758 Old Norcross Rd 3890 Johns Creek Pkwy 3890 Johns Creek Pkwy<br />
Ste 110 Ste 110 Ste 100 Ste 100<br />
Lawrenceville, GA 30045 Lawrenceville, GA 30043 Suwanee, GA 30024 Suwanee, GA 30024<br />
770-962-5552 678-985-7180 678-475-6595 678-475-6595<br />
Chaliff, Michael MD* Hendrix, Vernon MD* Meli, Richard MD* O’Brien, Sean MD*<br />
481 W Pike St 481 W Pike St 601 Professional Drive 481 W Pike St<br />
Ste 101 Ste 101 Ste 110 Ste 101<br />
Lawrenceville, GA 30045 Lawrenceville, GA 30045 Lawrenceville, GA 30045 Lawrenceville, GA 30045<br />
678-376-3550 678-376-3550 770-962-5552 678-376-3550<br />
Datoc, Patrick* Johnson, Alan MD* Meli, Richard MD* Ostrow, Todd*<br />
601 Professional Drive 481 West Pike Street 758 Old Norcross Rd 3890 Johns Creek Pkwy<br />
Ste 110 Lawrenceville, GA 30045 Ste 110 Ste 100<br />
Lawrenceville, GA 30045 678-376-3550 Lawrenceville, GA 30043 Suwanee, GA 30024<br />
770-962-5552 678-985-7180 678-475-6595<br />
Kallman, Douglas MD*<br />
Datoc, Patrick* 758 Old Norcross Rd Moss, Steven* Ostrow, Todd*<br />
758 Old Norcross Rd Ste 110 758 Old Norcross Rd 601 Professional Drive<br />
Ste 110 Lawrenceville, GA 30043 Ste 110 Ste 110<br />
Lawrenceville, GA 30043 678-985-7180 Lawrenceville, GA 30043 Lawrenceville, GA 30045<br />
678-985-7180 678-985-7180 770-962-5552<br />
Lee, Eugene*<br />
Falcon, Hugo MD* 3890 Johns Creek Pkwy Mulick, Arthur* Rim, Sharon MD*<br />
481 W Pike St Ste 100 481 West Pike Street 3890 Johns Creek Pkwy<br />
Ste 101 Suwanee, GA 30024 Lawrenceville, GA 30045 Ste 100<br />
Lawrenceville, GA 30045 678-475-6595 678-376-3550 Suwanee, GA 30024<br />
678-376-3550 678-475-6595<br />
Levy, Jason MD* Nicol, Mark*<br />
Feiner, Clifford MD* 3890 Johns Creek Pkwy 3890 Johns Creek Pkwy Schwartzberg, Daniel*<br />
3890 Johns Creek Pkwy Ste 100 Ste 100 1700 Tree Ln<br />
Ste 100 Suwanee, GA 30024 Suwanee, GA 30024 Ste 230<br />
Suwanee, GA 30024 678-475-6595 678-475-6595 Snellville, GA 30078<br />
678-475-6595 770-979-4700<br />
Levy, Jason MD* Nicol, Mark*<br />
Feiner, Clifford MD* 601 Professional Drive 601 Professional Drive Tippins, Russell MD*<br />
758 Old Norcross Rd Suite 110 Ste 110 3890 Johns Creek Pkwy<br />
Ste 110 Lawrenceville, GA 30045 Lawrenceville, GA 30045 Ste 100<br />
Lawrenceville, GA 30043 770-962-5552 770-962-5552 Suwanee, GA 30024<br />
678-985-7180 678-475-6595<br />
McIntosh, Thomas* Nixon, Kathleen MD*<br />
Gilbert, Stewart* 3890 Johns Creek Pkwy 3890 Johns Creek Pkwy Tippins, Russell MD*<br />
481 W Pike St Ste 100 Ste 100 601 Professional Drive<br />
Ste 101 Suwanee, GA 30024 Suwanee, GA 30024 Ste 110<br />
Lawrenceville, GA 30045 678-475-6595 678-475-6595 Lawrenceville, GA 30045<br />
678-376-3550 770-962-5552<br />
Page 34<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Diagnostic Ioachimescu, Adriana* Gastroenterology Parrish, Charles*<br />
Radiology cont. 1365 Clifton Rd NE 2665 N Decatur Rd<br />
- Ste B2200 DeKalb County Ste 550<br />
Gwinnett County Atlanta, GA 30322 Decatur, GA 30033<br />
cont. 404-778-5770 Balistreri, Anthony* 404-296-1986<br />
2675 N Decatur Rd Ste<br />
Tyber, Andy* Fulton County 506 Rausher, David*<br />
3890 Johns Creek Pkwy Decatur, GA 30033 2665 N Decatur Rd<br />
Ste 100 Ioachimescu, Adriana* 404-299-1679 Ste 550<br />
Suwanee, GA 30024 80 Jesse Hill Jr Dr SE -<br />
Decatur, GA 30033<br />
678-475-6595 OB/GYN<br />
Charukhchian, Samvel 404-296-1986<br />
Atlanta, GA 30303 MD*<br />
Tyber, Andy* 404-616-4646<br />
2012 Harobi Dr Stern, Mark*<br />
601 Professional Drive Suite B 2675 N Decatur Rd Ste<br />
Suite 110 Ioachimescu, Adriana* Tucker, GA 30084 506<br />
Lawrenceville, GA 30045 96 Armstrong St SE 404-477-0400 Decatur, GA 30033<br />
770-962-5552 Atlanta, GA 30303<br />
404-299-1679<br />
404-616-3730<br />
Disantis, Dennis*<br />
Tyrrell, Robert* 2675 N Decatur Rd Ste Fulton County<br />
601 Professional Drive Lowery, Jolene MD* 506<br />
Ste 110 75 Piedmont Avenue Decatur, GA 30033 Coe, Susan MD*<br />
Lawrenceville, GA 30045 Ste 600<br />
404-299-1679<br />
5671 Peachtree<br />
770-962-5552<br />
Atlanta, GA 30303<br />
Dunwoody Rd<br />
404-756-1410 Gbadehan, Olanrewaju Atlanta, GA 30342-5005<br />
Udoff, Eric MD* MD* 404-257-9000<br />
481 West Pike Street Lowery, Jolene MD* 5910 Hillandale Drive<br />
Lawrenceville, GA 30045 80 Jesse Hill Jr Dr Lithonia, GA 30058 Frist, Michael MD*<br />
678-376-3550 Atlanta, GA 30303 770-807-6088<br />
550 Peachtree Street NE<br />
404-616-5800 Suite 1600<br />
Vassiliades, Venetia Harris, Shirley* Atlanta, GA 30308<br />
MD* Osburne, Robert* 2665 N Decatur Rd 404-881-1094<br />
3890 Johns Creek Pkwy 265 Boulevard NE Ste 645<br />
Ste 100 2nd floor<br />
Decatur, GA 30033 Horney, John MD*<br />
Suwanee, GA 30024 Atlanta, GA 30312 404-294-8180<br />
5669 Peachtree<br />
678-475-6595<br />
404-265-4940 Dunwoody Rd NE<br />
Harris, Shirley* Ste 210<br />
Vemuri, Sreekanth* Reed, James MD* 5700 Hillandale Dr Atlanta, GA 30342<br />
3890 Johns Creek Pkwy 75 Piedmont Ave NE Ste 190 404-255-4333<br />
Ste 100 Ste 700<br />
Lithonia, GA 30058<br />
Suwanee, GA 30024 Atlanta, GA 30303 404-294-8180<br />
Kalmin, Bruce MD*<br />
678-475-6595<br />
404-756-1410 550 Peachtree St NE<br />
Harrison, Harold* Suite 1600<br />
Weaver, Carolyn* Shambaugh, George* 1918 Northlake Pkwy Atlanta, GA 30308<br />
3890 Johns Creek Pkwy 96 Armstrong St SE Tucker, GA 30084 678-223-7795<br />
Ste 100 Atlanta, GA 30303 770-723-0249<br />
Suwanee, GA 30024 404-616-3730 Kalmin, Bruce MD*<br />
678-475-6595<br />
High, Eric*<br />
5671 Peachtree<br />
Gwinnett County 2675 N Decatur Rd Ste Dunwoody Rd<br />
Endocrinology<br />
506 Ste 510<br />
Brown, Kevin MD* Decatur, GA 30033 Atlanta, GA 30342<br />
DeKalb County 3350 Paddocks Pkwy 404-299-1679 404-257-9000<br />
Suwanee, GA 30024<br />
Brandt, Stephen* 678-679-6210<br />
Kamean, Jeffrie* Lee, Yoon*<br />
1365 Clifton Road NE 2675 N Decatur Road Ste 1136 Cleveland Ave<br />
Bldg A, 2nd Fl 305 Atlanta, GA 30344<br />
Atlanta, GA 30322 Decatur, GA 30033 404-763-1606<br />
404-778-9729 404-299-8320<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 35<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Gastroenterology<br />
cont.<br />
Seibert, Andrew*<br />
600 Professional Dr Ste<br />
McClusky III, David*<br />
1365 Clifton Rd NE<br />
Speed, April MD*<br />
5900 Hillandale Drive<br />
Fulton County cont.<br />
130<br />
Lawrenceville, GA 30045<br />
Bldg A 3rd fl<br />
Atlanta, GA 30322<br />
Suite 335<br />
Lithonia, GA 30058<br />
Lucarelli, Kristina*<br />
770-995-7989 404-778-3712 404-501-8048<br />
1001 Johnson Ferry Rd<br />
General Surgery Phillips, Rogsbert* Stapleton, Sidney*<br />
NE 5910 Hillandale Dr 2665 N Decatur Rd<br />
Atlanta, GA 30342 DeKalb County Ste 104 Ste 350<br />
404-785-5252 Lithonia, GA 30058 Decatur, GA 30033<br />
Champney, Michael*<br />
Lucarelli, Kristina*<br />
678-418-3990 404-501-7081<br />
2665 N Decatur Rd<br />
341 Ponce de Leon Ste 730<br />
Quinones, Michael* Stapleton, Sidney*<br />
Avenue Decatur, GA 30033 2665 N Decatur Rd 5900 Hillandale Dr<br />
Atlanta, GA 30308 404-564-1958<br />
Ste 350 Ste 245<br />
404-616-6695 Decatur, GA 30033 Lithonia, GA 30058<br />
Fern, David*<br />
McGahan, Thomas MD*<br />
404-501-7081 404-501-7081<br />
2665 N Decatur Rd<br />
5669 Peachtree Ste 730<br />
Quinones, Michael* Steinberg, Scott*<br />
Ste 210 Decatur, GA 30033 2675 N Decatur Rd 2665 N Decatur Rd<br />
Atlanta, GA 30342 404-564-1958<br />
Decatur, GA 30033 Ste 350<br />
404-255-4333 404-501-9170 Decatur, GA 30033<br />
Fern, David*<br />
Sonenshine, Marc MD*<br />
404-501-7081<br />
2701 N Decatur RD Quinones, Michael*<br />
5671 Peachtree Decatur, GA 30033 5900 Hillandale Dr Steinberg, Scott*<br />
Dunwoody Rd 404-501-7925<br />
Ste 245 5900 Hillandale Dr<br />
Atlanta, GA 30342-5005 Lithonia, GA 30058 Ste 245<br />
404-257-9000 Gordon, Akil MD* 404-501-7081 Lithonia, GA 30058<br />
5910 Hillandale Dr Ste<br />
Sonenshine, Marc MD*<br />
404-501-7081<br />
209<br />
Rashid, Qammer*<br />
980 Johnson Ferry Rd Lithonia, GA 30058 2665 N Decatur Rd Stieber, Andrei*<br />
Ste 820 404-294-0257<br />
Ste 350 1364 Clifton Rd NE -<br />
Atlanta, GA 30342 Decatur, GA 30033 Anesthesiology<br />
404-252-9307 Hardcastle, William* 404-501-7081 Atlanta, GA 30322<br />
487 Winn Way Ste 103<br />
Trankina, Jon MD*<br />
404-778-3900<br />
Decatur, GA 30030 Scott, Andre*<br />
5671 Peachtree 404-296-0148<br />
2801 DeKalb Medical Stieber, Andrei*<br />
Dunwoody Rd NE Pkwy 1365 Clifton Rd NE<br />
Ste 510 Katz, Ian* Lithonia, GA 30058 Bldg A<br />
Atlanta, GA 30342-5005 2675 N Decatur Rd 404-501-8492 Atlanta, GA 30322-1013<br />
404-257-9000 Ste 611 404-778-2020<br />
Decatur, GA 30033 Scott, Andre*<br />
Gwinnett County 404-501-9377<br />
5910 Hillandale Dr Ste Stieber, Andrei*<br />
209 2665 N Decatur Rd<br />
Coe, Susan* Kennedy, John* Lithonia, GA 30058 Ste 730<br />
1600 Medical Way 2665 N Decatur Rd 404-294-0257 Decatur, GA 30033<br />
Ste 270 Ste 730 404-564-1958<br />
Snellville, GA 30078- Decatur, GA 30033 Siegel, Donald*<br />
2209 404-564-1958<br />
2801 N Decatur Rd Wilson, Kenneth MD*<br />
770-972-4780 Ste 180 1459 Montreal Rd<br />
McClusky III, David* Decatur, GA 30033 Ste 304<br />
Coe, Susan* 1365 Clifton Rd NE 404-297-0098 Tucker, GA 30084<br />
301 Philip Blvd Ste A3300 770-908-4444<br />
Lawrenceville, GA 30046- Atlanta, GA 30322<br />
8746 404-778-3712<br />
770-822-5560<br />
Page 36<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
General Surgery<br />
cont.<br />
Foster, Jacquelyn*<br />
80 Jesse Hill Jr Dr SE<br />
McCoy, James BS*<br />
75 Piedmont Ave NE<br />
Rosser Jr., James MD*<br />
1513 Cleveland Ave<br />
Fulton County<br />
Atlanta, GA 30303<br />
404-616-4396<br />
Ste 700<br />
Atlanta, GA 30303<br />
Atlanta, GA 30344<br />
404-752-1000<br />
Abend, Melvin MD*<br />
404-756-1410<br />
4553 N Shallowford Rd<br />
Henderson, Vernon MD*<br />
Rosser Jr., James MD*<br />
Ste 40 B<br />
285 Boulevard NE Mittenthal, Mark MD* 80 Jesse Hill Jr Dr<br />
Atlanta, GA 30388<br />
Ste 535 5669 Peachtree Atlanta, GA 30303<br />
770-455-3753<br />
Atlanta, GA 30312-4205 Dunwoody Rd NE 404-616-1415<br />
404-688-1444 Ste 100<br />
Babalola, Olufemi DO*<br />
Atlanta, GA 30342 Song, Hanjoon MD*<br />
1513 E Cleveland Ave<br />
Hwang, Steve MD* 404-256-0404<br />
3096 Peachtree Industrial<br />
Bldg 500<br />
1136 Cleveland Ave Blvd<br />
Atlanta, GA 30344<br />
Ste 408 Okoli, Joel MD* Duluth, GA 30097<br />
404-752-1000<br />
East Point, GA 30344 1513 Cleveland Ave 770-495-1477<br />
404-669-9080 Bldg 500<br />
Babalola, Olufemi DO*<br />
East Point, GA 30344 Souza, Renato*<br />
75 Piedmont Ave NE<br />
Jones, Frank MD* 404-752-1000<br />
204 Senoia Rd<br />
Ste 700<br />
1513 E Cleveland Ave Fairburn, GA 30213<br />
Atlanta, GA 30303<br />
Bldg 500 Okoli, Joel MD* 770-964-9759<br />
404-756-1410<br />
Atlanta, GA 30344 75 Piedmont Ave NE<br />
404-752-1000 Ste 700<br />
Srivastava, Shikha MD*<br />
Babalola, Olufemi DO*<br />
Atlanta, GA 30303 303 Parkway Drive<br />
80 Jesse Hill Jr Dr SE<br />
Jones, Frank MD* 404-756-1410<br />
Atlanta, GA 30312<br />
Atlanta, GA 30303<br />
75 Piedmont Avenue 404-265-4000<br />
404-616-1415<br />
Ste 700<br />
Okoli, Joel MD*<br />
Atlanta, GA 30303 80 Jesse Hill Jr Drive SE Vivek, Uthan*<br />
Beech, Derrick* 404-756-1400 Atlanta, GA 30303 3400 Old Milton Parkway<br />
75 Piedmont Ave<br />
404-616-7578<br />
Suite 300-A<br />
Ste 700<br />
Jones, Frank MD* Alpharetta, GA 30005<br />
Atlanta, GA 30303<br />
80 Jesse Hill Jr Dr SE Patel, Vijaykumar MD* 770-771-5260<br />
404-756-1400<br />
Atlanta, GA 30303 1513 East Cleveland<br />
404-616-4396 East Point, GA 30344 Williams, Michael*<br />
Beech, Derrick*<br />
404-756-5764<br />
5755 North Point Pkwy<br />
80 Jesse Hill Jr Dr<br />
Macik, Paul MD* Suite 223<br />
Atlanta, GA 30303<br />
960 Johnson Ferry Road Patel, Vijaykumar MD* Alpharetta, GA 30022<br />
404-616-5800<br />
East 2800 Springdale Rd 770-500-3660<br />
Suite 228 Atlanta, GA 30315<br />
Childs, Ed MD* Atlanta, GA 30342 404-616-8100<br />
Wilson, Kenneth MD*<br />
75 Piedmont Rd 404-252-2220<br />
1136 Cleveland Ave Ste<br />
Ste 700<br />
Patel, Vijaykumar MD* 611<br />
Atlanta, GA 30303<br />
Matthews, Leslie MD* 75 Piedmont Avenue Atlanta, GA 30344<br />
404-756-1480<br />
75 Piedmont Ave Ste. 700 404-768-9350<br />
Ste 700 Atlanta, GA 30303<br />
Childs, Ed MD* Atlanta, GA 30303 404-756-5764<br />
Wilson, Kenneth MD*<br />
80 Jesse Hill Jr Dr 404-756-5271<br />
80 Jesse Hill Jr Dr SE<br />
Atlanta, GA 30303<br />
Patel, Vijaykumar MD* Atlanta, GA 30303<br />
404-616-5800<br />
McClusky III, David* 80 Jesse Hill Jr Dr 404-616-4396<br />
550 Peachtree St NE Atlanta, GA 30303<br />
Danner, Omar* 8th fl 404-616-5800<br />
Winston, Alan*<br />
80 Jesse Hill Jr Dr SE Atlanta, GA 30308<br />
5665 Peachtree<br />
Atlanta, GA 30303 404-686-8143<br />
Poindexter, James MD* Dunwoody Rd<br />
404-616-1415<br />
1718 Peachtree Street Ste 200<br />
North West Atlanta, GA 30342<br />
Ste 360 404-252-6104<br />
Atlanta, GA 30309<br />
404-350-9505<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 37<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
General Surgery Genetics<br />
Fulton County Haynes, Nicole*<br />
cont.<br />
1000 Johnson Ferry Rd<br />
Fulton County Gardner, Colleen NP*<br />
Gwinnett County<br />
NE<br />
1000 Johnson Ferry Rd Atlanta, GA 30342<br />
Duncan, Thomas*<br />
Spiro, Rhonda* NE 404-851-8988<br />
1000 Medical Center Blvd<br />
1001 Johnson Ferry Rd Atlanta, GA 30342<br />
Lawrenceville, GA 30046 NE 404-851-8988 Haynes, Nicole*<br />
678-312-4616<br />
Atlanta, GA 30342<br />
1015 Mansell Road<br />
404-785-5252 Gardner, Colleen* Roswell, GA 30076<br />
Elsey, James MD*<br />
1015 Mansell Road 678-352-0254<br />
631 Professional Dr.<br />
Spiro, Rhonda* Roswell, GA 30076<br />
Ste 300<br />
5455 Meridian Mark Rd 678-352-0254 Haynes, Nicole*<br />
Lawrenceville, GA 30046<br />
Ste 200<br />
3000 Hospital Blvd<br />
Atlanta, GA 30342 Gardner, Colleen NP*<br />
770-962-9977<br />
Roswell, GA 30076<br />
404-785-2239 3000 Hospital Blvd 770-751-2509<br />
Kim, Sun-Hee MD*<br />
Roswell, GA 30076<br />
6185 Buford Hwy Gynecology 770-751-2509 Haynes, Nicole*<br />
Bldg G<br />
6325 W Johns Crossing<br />
Gardner, Colleen NP*<br />
Norcross, GA 30071<br />
DeKalb County<br />
Bldg 100, Ste 209<br />
980 Johnson Ferry Road<br />
770-446-0929<br />
Duluth, GA 30097<br />
Gann, Joyce* Ste 660<br />
678-805-2246<br />
Kramer, Andrew MD*<br />
2685 Milscott Dr Atlanta, GA 30342<br />
1700 Tree Lane Road<br />
Decatur, GA 30033 404-255-2057 Haynes, Nicole*<br />
Ste 410<br />
678-904-7210<br />
6335 Hospital Parkway<br />
Gardner, Colleen*<br />
Snellville, GA 30078<br />
Suite 209<br />
Malloy, Tyrone MD* 980 Johnson Ferry Road<br />
770-972-7999<br />
Duluth, GA 30097<br />
4201 Rainbow Dr Suite 660<br />
678-805-2246<br />
Moomey, Charles MD*<br />
Decatur, GA 30034 Atlanta, GA 30342<br />
600 Professional Dr<br />
404-534-0035<br />
404-255-2057 Haynes, Nicole*<br />
Ste 250<br />
980 Johnson Ferry Road<br />
Sharma, Rita* Gross, Gail MD*<br />
Lawrenceville, GA 30045<br />
Ste 660<br />
1922 Northlake Pkwy 1000 Johnson Ferry Rd<br />
770-962-9977<br />
Atlanta, GA 30342<br />
Tucker, GA 30084 NE<br />
404-255-2057<br />
Moomey, Charles MD*<br />
770-723-1545<br />
Atlanta, GA 30342<br />
631 Professional Dr<br />
404-256-8000 Lovelady, Alecia MD*<br />
Sharma, Rita*<br />
Ste 300<br />
1720 Phoenix Blvd<br />
2175 Northlake Pkwy Gross, Gail MD*<br />
Lawrenceville, GA 30046<br />
Ste 700<br />
Bldg 4 1015 Mansell Rd<br />
770-962-9977<br />
Atlanta, GA 30349<br />
Tucker, GA 30084 Roswell, GA 30076 404-446-4792<br />
Pavamani, E MD*<br />
770-723-1545<br />
678-352-0254<br />
1700 Tree Lane Rd<br />
Malloy, Tyrone MD*<br />
Smith, Dominique* Gross, Gail MD*<br />
Ste 390<br />
6210 Old National Hwy<br />
5900 Hillandale Drive 6335 Hospital Parkway<br />
Snellville, GA 30078-<br />
Atlanta, GA 30349<br />
Annex A Ste 209<br />
6745<br />
770-991-7552<br />
Lithonia, GA 30058 Duluth, GA 30097<br />
770-972-7999 678-418-6990<br />
404-255-2057 Thomas Burse, Janella*<br />
Steinberg, Scott*<br />
1720 Phoenix Blvd<br />
Thomas Burse, Janella* Gross, Gail MD*<br />
3490 Pleasant Hill Rd<br />
Ste 700<br />
770 Village Square Drive 980 Johnson Ferry Rd Ne<br />
Snellville, GA 30078<br />
Atlanta, GA 30349<br />
Stone Mountain, GA Suite 660<br />
770-814-2870<br />
404-446-4792<br />
30083<br />
Atlanta, GA 30342<br />
404-298-8998<br />
404-255-2057 Williams, Robert MD*<br />
Steinberg, Scott*<br />
455 Beaver Ruin Rd<br />
1595 W Cleveland<br />
Lilburn, GA 30047<br />
Avenue<br />
770-923-7778<br />
East Point, GA 30344<br />
404-616-2886<br />
Page 38<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Gynecology cont. Haynes, Nicole* Hematology Hematology/<br />
1000 Medical Center Blvd Oncology<br />
Fulton County cont. Lawrenceville, GA 30045 DeKalb County<br />
678-442-4321<br />
Williams, Robert MD*<br />
Clarke County<br />
Anthony, Charmaine*<br />
75 Piedmont Ave Haynes, Nicole* 1405 Clifton Rd NE Loyd, Richard*<br />
Ste 700 500 Medical Center Blvd Atlanta, GA 30322 125 King Ave<br />
Atlanta, GA 30303 Ste 210 404-785-6000 Ste 200<br />
404-756-1400 Lawrenceville, GA 30045 Athens, GA 30606<br />
770-822-3344 Simpson, Lijo MD*<br />
Williams, Robert MD*<br />
706-369-4478<br />
2665 N Decatur Rd Ste<br />
80 Jesse Hill Jr Dr SE Gynecology / 740<br />
DeKalb County<br />
Atlanta, GA 30303<br />
Oncology<br />
Decatur, GA 30033<br />
404-616-1415 404-321-1950 Bradley, Tajuana*<br />
DeKalb County<br />
2712 Lawrenceville Hwy<br />
Williams, Robert MD* Fulton County Decatur, GA 30033<br />
809 Cleveland Ave SW Lawhead, Raymond* 770-496-5555<br />
Ste 101<br />
1459 Montreal Rd<br />
Anthony, Charmaine*<br />
Atlanta, GA 30315 Tucker, GA 30084<br />
1001 Johnson Ferry Rd Carter, Richard*<br />
404-763-3600 404-265-3614<br />
NE<br />
2665 N Decatur Rd Ste<br />
Atlanta, GA 30342 740<br />
Zimmermann, Julie*<br />
Fulton County 404-785-5252 Decatur, GA 30033<br />
1015 Mansell Rd 404-321-1950<br />
Roswell, GA 30076 Ellison, Margarett* Anthony, Charmaine*<br />
678-352-0254 960 Johnson Ferry Rd 33 Jesse Hill Jr Dr Loyd, Richard*<br />
Ste 130<br />
Atlanta, GA 30303 2712 Lawrenceville Hwy<br />
Zimmermann, Julie*<br />
Atlanta, GA 30342 404-785-9800 Decatur, GA 30033<br />
6335 Hospital Parkway<br />
404-300-2990<br />
770-496-5555<br />
Ste 209<br />
Anthony, Charmaine*<br />
Duluth, GA 30097 Feuer, Gerald*<br />
35 Jesse Hill Jr Dr Mamby, Celia*<br />
404-255-2057 980 Johnson Ferry Rd Atlanta, GA 30303 2712 Lawrenceville Hwy<br />
Ste 1080<br />
404-785-9500 Decatur, GA 30033<br />
Zimmermann, Julie*<br />
Atlanta, GA 30342<br />
770-496-5555<br />
980 Johnson Ferry Road<br />
404-459-1900<br />
Anthony, Charmaine*<br />
Suite 620<br />
5445 Meridian Mark Rd Mamby, Celia*<br />
Atlanta, GA 30342<br />
Ste 500<br />
Hand Surgery<br />
2745 DeKalb Medical<br />
404-255-2057 Atlanta, GA 30342 Parkway<br />
Fulton County 404-785-3820 Suite 110<br />
Gwinnett County Lithonia, GA 30058<br />
Ratner, Joshua MD* Sarmiento, Ruth*<br />
Gann, Joyce*<br />
770-981-5431<br />
5455 Meridian Mark Rd 1136 Cleveland Ave<br />
1700 Tree Ln Ste 200<br />
Ste 200<br />
Ste 514 Srinivasiah, Jayanthi*<br />
Snellville, GA 30078<br />
Atlanta, GA 30342 East Point, GA 30344 2675 N Decatur Rd<br />
678-904-7210<br />
404-785-2239<br />
770-692-9371 Ste 701<br />
Gardner, Colleen NP*<br />
Decatur, GA 30033<br />
Ratner, Joshua MD* Sarmiento, Ruth*<br />
1000 Medical Center Blvd<br />
404-294-8750<br />
980 Johnson Ferry Rd NE 3886 Princeton Lakes<br />
Lawrenceville, GA 30045<br />
Ste 1020<br />
Way SE Srinivasiah, Jayanthi*<br />
678-442-4321<br />
Atlanta, GA 30342 Atlanta, GA 30331 2712 Lawrenceville Hwy<br />
770-692-9371<br />
Gardner, Colleen NP* 404-256-8966<br />
Decatur, GA 30033<br />
500 Medical Center Blvd<br />
770-496-5555<br />
Weens, Joan MD*<br />
Ste 210 5670 Peachtree Tamim, Hiba*<br />
Lawrenceville, GA 30045 Dunwoody Rd NE 2665 N Decatur Rd Ste<br />
770-822-3344 Ste 1100 740<br />
Atlanta, GA 30342 Decatur, GA 30033<br />
404-851-2340 404-321-1950<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 39<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Hematology/ Piper, Jennifer* Loyd, Richard* Wurapa, Anson*<br />
Oncology cont. 550 Peachtree St NE 601 Professional Drive 2665 N Decatur Rd<br />
Ste 1185 Ste 260 Ste 330<br />
Fulton County Atlanta, GA 30308 Lawrenceville, GA 30045 Decatur, GA 30033<br />
404-223-0792 770-822-0788 404-297-9755<br />
Bradley, Tajuana*<br />
6335 Hospital Pkwy Sarmiento, Ruth* Srinivasiah, Jayanthi* Fulton County<br />
Ste 107 1136 Cleveland Ave 601 Professional Drive<br />
Duluth, GA 30097 Ste 514 Ste 260<br />
Dailey, Michael MD*<br />
866-222-3688 East Point, GA 30344 Lawrenceville, GA 30045 11660 Alpharetta Hwy<br />
770-692-9371 770-822-0788<br />
Ste 430<br />
Colbert, Laronna* Roswell, GA 30076<br />
75 Piedmont Ave Sarmiento, Ruth* Rockdale County 770-255-1069<br />
Ste 700<br />
3886 Princeton Lakes<br />
Atlanta, GA 30303 Way SE<br />
Carter, Richard* Dickensheets, David<br />
404-756-1400 Atlanta, GA 30331 1498 Klondike Rd MD*<br />
770-692-9371<br />
Ste 106<br />
11660 Alpharetta Hwy<br />
Delgrosso Burt, Cassie* Conyers, GA 30094 Ste 430<br />
550 Peachtree St NE Srinivasiah, Jayanthi* 404-761-7260 Roswell, GA 30076<br />
Ste 1185 6325 W Johns Crossing 770-255-1069<br />
Atlanta, GA 30308 Bldg 1000<br />
Mamby, Celia*<br />
404-223-0792 Duluth, GA 30097 1364 Wellbrook Cir Ne Drayton, Joyce MD*<br />
770-623-8965<br />
Conyers, GA 30012 1 Baltimore Pl<br />
Fernando, Nishan MD* 770-760-9949 Ste 360<br />
3330 Preston Ridge Rd Whaley, William* Atlanta, GA 30308<br />
Ste 110 1100 Johnson Ferry Infectious 404-863-9781<br />
Alpharetta, GA 30005 Center Point I Bldg Disease<br />
678-566-6995 Ste 600<br />
Ughwanogho, Ovie MD*<br />
Atlanta, GA 30342 DeKalb County 1203 Cleveland Ave<br />
Franco, Carlos MD,<br />
404-256-4777<br />
Ste 1B<br />
MPH* Boden, Milton* Atlanta, GA 30344<br />
1100 Johnson Ferry Greene County 2665 N Decatur Rd 404-768-2669<br />
Center Point I Bldg Ste 330<br />
Ste 600 Loyd, Richard* Decatur, GA 30033 Gwinnett County<br />
Atlanta, GA 30342 1000 Cowles Clinic Way 404-297-9755<br />
404-256-4777 Magnolia Bldg Ste M-200<br />
Martin, Paul MD*<br />
Greensboro, GA 30642 Bressler, Adam* 575 Professional Dr<br />
Franco, Carlos MD, 866-223-4076 2665 N Decatur Rd Ste 370<br />
MPH* Ste 330<br />
Lawrenceville, GA 30046<br />
3330 Preston Ridge Rd Gwinnett County Decatur, GA 30033 770-995-0466<br />
Ste 110 404-297-9755<br />
Alpharetta, GA 30005 Afshani, Victoria MD*<br />
Raizes, Elliot MD*<br />
678-566-6995 1800 Tree Ln Dretler, Robin* 3075 Breckingridge Blvd<br />
Ste 180 2665 N Decatur Rd Ste 415<br />
Piper, Jennifer* Snellville, GA 30078 Ste 330<br />
Duluth, GA 30096<br />
1100 Johnson Ferry Rd 770-979-4177 Decatur, GA 30033 770-962-8396<br />
NE 404-297-9755<br />
Ste 600<br />
Bradley, Tajuana*<br />
Raizes, Elliot MD*<br />
Atlanta, GA 30342 698 Duluth Hwy Nguyen, Hieu*<br />
575 Professional Dr<br />
404-256-4777 Ste 201 2665 N Decatur Rd Ste 370<br />
Lawrenceville, GA 30045 Ste 330<br />
Lawrenceville, GA 30046<br />
Piper, Jennifer* 866-222-3688 Decatur, GA 30033 770-995-0466<br />
3330 Preston Ridge Rd 404-297-9755<br />
Ste 110<br />
Alpharetta, GA 30005<br />
678-566-6995<br />
Page 40<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Infectious<br />
Schwartzberg, Daniel* Alizadeh, Aaron* Fulton County<br />
Disease cont. 1252 North Ave NE 2712 Lawrenceville Hwy<br />
Atlanta, GA 30307 Decatur, GA 30033 Badnin, Martha*<br />
Gwinnett County 404-522-5828 770-496-5555<br />
1100 Johnson Ferry Rd<br />
cont.<br />
NE<br />
Schwartzberg, Daniel* James, Mylene* Ste 600<br />
Vassilev, Tzvetan MD* 303 Parkway Dr NE 2712 Lawrenceville Hwy Atlanta, GA 30342<br />
575 Professional Dr Atlanta, GA 30312 Decatur, GA 30033 404-256-4777<br />
Ste 370 404-265-4565 770-496-5555<br />
Lawrenceville, GA 30046<br />
Badnin, Martha*<br />
770-995-0466<br />
Schwartzberg, Daniel* James, Mylene* 3330 Preston Ridge Rd<br />
303 Parkway Dr Ne 2745 DeKalb Medical Ste 110<br />
Interventional Atlanta, GA 30312 Pkwy Alpharetta, GA 30005<br />
Radiology<br />
404-459-8440 Ste 110 866-222-8248<br />
Lithonia, GA 30058<br />
DeKalb County Gwinnett County 866-222-3688<br />
Bashey, Asad MD*<br />
5670 Peachtree<br />
Gilbert, Stewart* Gilbert, Stewart* Loyd, Richard* Dunwoody Rd NE<br />
2774 N Decatur Rd 481 W Pike St 2712 Lawrenceville Hwy Ste 100<br />
Decatur, GA 30033 Ste 101 Decatur, GA 30033 Atlanta, GA 30342<br />
404-292-2277<br />
Lawrenceville, GA 30045 770-496-5555 404-255-1930<br />
678-376-3550<br />
Grossman, Clifford*<br />
McMillan, Ian*<br />
Bowen, Kristina MD*<br />
2774 N Decatur Rd Schwartzberg, Daniel* 2712 Lawrenceville Hwy 1100 Johnson Ferry<br />
Decatur, GA 30033 1700 Tree Ln Decatur, GA 30033 Center Point I Bldg<br />
404-292-2277<br />
Ste 230 770-496-5555 Ste 600<br />
Snellville, GA 30078 Atlanta, GA 30342<br />
Price, Robert* 770-979-4700<br />
Oropo, Sikirat* 404-256-4777<br />
2774 N Decatur Rd<br />
2712 Lawrenceville Hwy<br />
Ste B<br />
Medical<br />
Decatur, GA 30033 Bowen, Kristina MD*<br />
Decatur, GA 30033 Oncology<br />
770-496-5555 3330 Preston Ridge Rd<br />
404-299-2887<br />
Ste 110<br />
Clarke County Oropo, Sikirat* Alpharetta, GA 30005<br />
Fulton County 2745 DeKalb Medical 678-566-6995<br />
Loyd, Richard* Pkwy<br />
Gilbert, Stewart* 125 King Ave<br />
Ste 110 Carr, Daniel MD*<br />
303 Parkway Dr NE Ste 200<br />
Lithonia, GA 30058 550 Peachtree St Ne<br />
Atlanta, GA 30312 Athens, GA 30606 866-222-3688 Ste 1185<br />
404-265-4565 706-369-4478<br />
Atlanta, GA 30308<br />
Srinivasiah, Jayanthi* 404-223-0792<br />
Jeffries, Barry* DeKalb County 2675 N Decatur Rd<br />
303 Parkway Dr Ne Ste 701 Colbert, Laronna*<br />
Atlanta, GA 30312 Aduloju, Simbo MD* Decatur, GA 30033 75 Piedmont Ave<br />
404-459-8440 2712 Lawrenceville Hwy 404-294-8750 Ste 700<br />
Decatur, GA 30033 Atlanta, GA 30303<br />
Price, Robert*<br />
770-496-5555 Srinivasiah, Jayanthi* 404-756-1400<br />
303 Parkway Dr 2712 Lawrenceville Hwy<br />
Atlanta, GA 30312 Aduloju, Simbo MD* Decatur, GA 30033 Goldklang, Gerald MD*<br />
404-265-4565 2745 DeKalb Medical 770-496-5555 320 Parkway Dr<br />
Parkway<br />
2nd Fl Flex Clinic<br />
Price, Robert* Suite 110 Atlanta, GA 30312<br />
993 Johnson Ferry Rd NE Lithonia, GA 30058 404-223-0792<br />
Atlanta, GA 30342 770-981-5431<br />
404-303-0707<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 41<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
Medical<br />
Oncology cont.<br />
Fulton County cont.<br />
Goldklang, Gerald MD*<br />
3886 Princeton Lakes<br />
Way SW<br />
Ste 200<br />
Atlanta, GA 30331<br />
404-349-7300<br />
James, Mylene*<br />
6335 Hospital Pkwy<br />
Ste 107<br />
Duluth, GA 30097<br />
866-222-3688<br />
Lesesne, Joseph MD*<br />
1100 Johnson Ferry<br />
Center Point I Bldg<br />
Ste 600<br />
Atlanta, GA 30342<br />
404-256-4777<br />
Norris, Cheryl*<br />
1100 Johnson Ferry Rd<br />
NE<br />
Ste 600<br />
Atlanta, GA 30342<br />
404-256-4777<br />
Sarmiento, Ruth*<br />
1136 Cleveland Ave<br />
Ste 514<br />
East Point, GA 30344<br />
770-692-9371<br />
Sarmiento, Ruth*<br />
3886 Princeton Lakes<br />
Way SE<br />
Atlanta, GA 30331<br />
770-692-9371<br />
Srinivasiah, Jayanthi*<br />
6325 W Johns Crossing<br />
Bldg 1000<br />
Duluth, GA 30097<br />
770-623-8965<br />
Subbannan, Karthi MD*<br />
3330 Preston Ridge Rd<br />
Ste 110<br />
Alpharetta, GA 30005<br />
678-566-6995<br />
List of Plan <strong>Provider</strong>s<br />
Subbannan, Karthi MD*<br />
6335 Hospital Parkway<br />
James, Mylene*<br />
698 Duluth Hwy<br />
Nephrology<br />
Ste107 Ste 201 DeKalb County<br />
Duluth, GA 30097 Lawrenceville, GA 30045<br />
770-623-8965 866-222-3688<br />
Cleveland, William MD*<br />
1987 Candler Rd<br />
Thomas, Sherine MD* Leguizamo, Jorge* Decatur, GA 30032<br />
1000 Hawthorne Ave 1800 Tree Lane 404-534-0183<br />
Ste J Ste 250<br />
Atlanta, GA 30306 Snellville, GA 30078 Cleveland, William MD*<br />
706-369-4478 770-979-4177<br />
2485 Park Central Blvd<br />
Decatur, GA 30035<br />
Tolbert, Ethan MD* Leguizamo, Jorge* 404-696-7300<br />
320 Parkway Dr 1800 Tree Lane<br />
2nd Fl Flex Clinic Ste 180<br />
Elmore, Kathryn*<br />
Atlanta, GA 30312 Snellville, GA 30078 497 Winn Way<br />
404-223-0792 770-979-4177<br />
Ste A<br />
Decatur, GA 30030<br />
Tolbert, Ethan MD* Leguizamo, Jorge* 404-294-7033<br />
550 Peachtree St Ne 1800 Tree Lane<br />
Ste 1185 Ste 250<br />
Elmore, Kathryn*<br />
Atlanta, GA 30308 Snellville, GA 30078 5250 Snapfinger Park Dr<br />
404-223-0792 770-979-4177<br />
Decatur, GA 30035<br />
404-294-7033<br />
Weakland, Laura MD* Leguizamo, Jorge*<br />
3886 Princeton Lakes 1800 Tree Lane Ihenacho, Nicholas MD*<br />
Way SW Ste 180<br />
5329 Memorial Dr<br />
Ste 200 Snellville, GA 30078 Ste B<br />
Atlanta, GA 30331 770-979-4177<br />
Stone Mountain, GA<br />
404-349-7300<br />
30083<br />
Leguizamo, Jorge* 404-296-7695<br />
Weakland, Laura MD* 698 Duluth Highway<br />
550 Peachtree St Ne Ste 201<br />
Ihenacho, Nicholas MD*<br />
Ste 1185 Lawrenceville, GA 30045 5405 Memorial Drive<br />
Atlanta, GA 30308 770-822-0788<br />
Bldg C<br />
404-223-0792<br />
Stone Mountain, GA<br />
Loyd, Richard* 30083<br />
Greene County 601 Professional Drive 404-296-7695<br />
Ste 260<br />
Loyd, Richard* Lawrenceville, GA 30045 Muro, Karen*<br />
1000 Cowles Clinic Way 770-822-0788<br />
497 Winn Way<br />
Magnolia Bldg Ste M-200<br />
Ste A<br />
Greensboro, GA 30642 Srinivasiah, Jayanthi* Decatur, GA 30030<br />
866-223-4076<br />
601 Professional Drive 404-294-7033<br />
Ste 260<br />
Gwinnett County Lawrenceville, GA 30045 Muro, Karen*<br />
770-822-0788<br />
5250 Snapfinger Park Dr<br />
Alizadeh, Aaron* Decatur, GA 30035<br />
1800 Tree Ln Rockdale County 404-294-7033<br />
Ste 180<br />
Snellville, GA 30078 Alizadeh, Aaron* Murphy, Saied MD*<br />
770-979-4177<br />
1501 Milstead Rd NE 1350 Montreal Rd<br />
Ste 110<br />
Ste 210<br />
Conyers, GA 30012 Tucker, GA 30084<br />
770-760-9949<br />
404-252-2546<br />
Page 42<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Nephrology cont. Muhammedi, Rockdale County Ranta, Annemarei*<br />
Muhammed MD*<br />
2665 N Decatur Rd Ste<br />
Fulton County 777 Cleveland Ave Sw Elmore, Kathryn* 630<br />
Ste 516 1368 Wellbrook Circle<br />
Agbogu, Bob MD*<br />
Decatur, GA 30033<br />
Atlanta, GA 30315 Conyers, GA 30012<br />
1136 Cleveland Ave<br />
404-294-3040<br />
404-761-0819<br />
404-294-7033<br />
Ste 500<br />
Schub, Howard MD*<br />
East Point, GA 30344 Murphy, Saied MD* Joshi, Biren*<br />
1920 Briarcliff Rd NE<br />
404-669-9669 980 Johnson Ferry Rd 1368 Wellbrook Circle Atlanta, GA 30329<br />
Ste 40 Conyers, GA 30012<br />
Agbogu, Bob MD*<br />
404-256-3535<br />
Atlanta, GA 30342 404-294-7033<br />
1170 Cleveland Ave<br />
404-252-2546<br />
Shuler, Sara MD*<br />
Atlanta, GA 30344 Muro, Karen* 2665 North Decatur Rd<br />
404-305-3500 Obialo, Chamberlain* 1368 Wellbrook Circle Ste 630<br />
75 Piedmont Ave NE Conyers, GA 30012<br />
Bashir, Khalid MD*<br />
Decatur, GA 30033<br />
Ste 700 404-294-7033<br />
75 Piedmont Rd<br />
404-501-7555<br />
Ste 700<br />
Atlanta, GA 30303<br />
404-756-1410 Neurology Tesfaye, Daniel*<br />
Atlanta, GA 30303<br />
5910 Hillandale Dr<br />
404-756-1480 Obialo, Chamberlain* DeKalb County Suite 205<br />
Cleveland, William MD*<br />
80 Jesse Hill Jr Drive SE Lithonia, GA 30058<br />
Atlanta, GA 30303<br />
Berenson, Frank*<br />
121 Linden Ave NE<br />
404-501-8354<br />
404-616-7578<br />
1920 Briarcliff Rd NE<br />
Ste 102 Atlanta, GA 30329 Turknett, Joshua*<br />
Atlanta, GA 30331<br />
Gwinnett County 404-256-3535 2665 N Decatur Rd<br />
404-815-7217 Ste 540<br />
Abdalla, Mazen* Derossett, Sarah*<br />
Cleveland, William MD*<br />
Decatur, GA 30033<br />
2386 Clower Street 2665 N Decatur Rd Ste<br />
2669 Church St<br />
404-508-4008<br />
Ste#C-105<br />
630<br />
Atlanta, GA 30344<br />
Snellville, GA 30078 Decatur, GA 30033 Turknett, Joshua*<br />
404-209-0113<br />
678-344-0334<br />
404-294-3040 5900 Hillandale Dr<br />
Cleveland, William MD*<br />
Mob 1 Annex A Ste 335<br />
Harish, Dwarakinath Nash, Marshall*<br />
3620 Martin Luther King<br />
Lithonia, GA 30058<br />
MD* 2665 N Decatur Rd<br />
Jr Dr SW<br />
404-508-4008<br />
601 Professional Dr Ste 540<br />
Atlanta, GA 30331<br />
Ste 340<br />
Decatur, GA 30033 Weissman, Joseph*<br />
404-696-7300<br />
Lawrenceville, GA 30045 404-508-4008 2665 N Decatur Rd<br />
Ellis, Reuben*<br />
678-377-3305<br />
Ste 630<br />
Nash, Marshall*<br />
3620 Martin Luther King<br />
Decatur, GA 30033<br />
Muro, Karen* 5900 Hillandale Dr<br />
Jr Dr SW<br />
404-294-3040<br />
2096 Mcgee Rd Mob 1 Annex A Ste 335<br />
Atlanta, GA 30331<br />
Snellville, GA 30078 Lithonia, GA 30058 Forsyth County<br />
404-696-7300<br />
404-294-7033<br />
404-508-4008<br />
Olson, David*<br />
Emelife, Charmaine*<br />
Shah, Kirti MD* Olson, David*<br />
1200 Northside Forsyth<br />
777 Cleveland Ave Sw<br />
605 Old Norcross Rd 2665 N Decatur Rd Dr<br />
Ste 516<br />
Lawrenceville, GA 30046 Ste 540<br />
Cumming, GA 30041<br />
Atlanta, GA 30315<br />
770-962-1231 Decatur, GA 30033 770-844-3230<br />
404-761-0819 404-508-4008<br />
Newton County<br />
Olson, David*<br />
Iqbal, Khalid MD* Olson, David* 1200 Northside Forsyth<br />
777 Cleveland Ave Sw Muro, Karen*<br />
5900 Hillandale Dr Dr<br />
Ste 516 7215 Industrial Blvd Ne Mob 1 Annex A Ste 335 Cumming, GA 30041-<br />
Atlanta, GA 30315 Covington, GA 30014 Lithonia, GA 30058 7659<br />
404-761-0819 404-294-7033 404-508-4008<br />
404-851-6936<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 43<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Neurology cont. Wamer, Angela* Khajavi, Kaveh* Obstetrics &<br />
265 Boulevard NE 2675 N Decatur Rd<br />
Fulton County Gynecology<br />
2nd floor Ste 710<br />
Berenson, Frank*<br />
Atlanta, GA 30312 Decatur, GA 30033 Carroll County<br />
5455 Meridian Mark Rd<br />
404-265-4940 404-299-3338<br />
Ste 200<br />
Raynor, B Denise MD*<br />
Wamer, Angela* Fulton County<br />
Atlanta, GA 30342<br />
527 North Ave<br />
285 Boulevard NE<br />
404-785-2239<br />
Villa Rica, GA 30180<br />
Ste 345 Disch, Steven MD* 678-729-9415<br />
Atlanta, GA 30312 2500 Hospital Blvd<br />
Berenson, Frank*<br />
404-653-0159 Suite 310<br />
5505 Peachtree<br />
Clayton County<br />
Roswell, GA 30076-4947<br />
Dunwoody Rd NE Yarde, William* 770-664-9600<br />
Raynor, B Denise MD*<br />
Ste 500 1136 Cleveland Ave Ste 238 Professional Court<br />
Atlanta, GA 30342 621 Yarde, William* Riverdale, GA 30274<br />
404-256-3535 Atlanta, GA 30344 1136 Cleveland Ave Ste 770-471-7402<br />
404-530-0287<br />
621<br />
Griffith, Patrick MD*<br />
Atlanta, GA 30344 DeKalb County<br />
75 Piedmont Avenue<br />
Gwinnett County 404-530-0287<br />
Ste 700<br />
Assevero, Michael*<br />
Atlanta, GA 30303 Houssami, Yazan* Gwinnett County 4166 Buford Hwy Ne Ste<br />
404-756-1410 600 Professional Drive 1029<br />
Ste 110 Ehirim, Princewill MD* Atlanta, GA 30341<br />
Jacquez, Fanny*<br />
Lawrenceville, GA 30045 500 Medical Center Blvd 404-417-9360<br />
2020 Peachtree Rd NE<br />
770-995-0555<br />
Ste 200<br />
Atlanta, GA 30309<br />
Lawrenceville, GA 30046 Bonk, Catherine*<br />
404-352-2020 Williamson, Mitchell 678-916-7053<br />
315 Winn Way<br />
MD* Decatur, GA 30030<br />
Loring, Sherrill MD*<br />
600 Professional Drive Nuclear Medicine 404-299-9724<br />
2020 Peachtree Rd NE<br />
Ste 110<br />
Atlanta, GA 30309<br />
Lawrenceville, GA 30045 DeKalb County Bowen, Genesis*<br />
404-352-2020<br />
770-995-0555<br />
1805 Parke Plaza Circle<br />
Mulick, Arthur* Ste 102<br />
Phan, Han MD*<br />
Neuroradiology 2774 N Decatur Rd Stone Mountain, GA<br />
1100 Lake Hearn Dr NE Decatur, GA 30033 30087<br />
Ste 450<br />
Fulton County 404-292-2277 770-469-9961<br />
Atlanta, GA 30342<br />
404-252-7339 Ouanounou, Serge* Fulton County Bowen, Genesis*<br />
1100 Johnson Ferry Rd<br />
2801 North Decatur Rd<br />
Phan, Han MD*<br />
Ne Ste 245<br />
Daya, Shashikant* Ste 190<br />
3300 Old Milton Parkway<br />
Atlanta, GA 30342 3305 Bobby Brown Pkwy Decatur, GA 30033<br />
STE 300<br />
404-256-5193<br />
Atlanta, GA 30344 404-299-9307<br />
Alpharetta, GA 30005 404-806-8181<br />
404-252-7339<br />
Neurosurgery Brown, Pamela*<br />
Mulick, Arthur* 1805 Parke Plaza Cir<br />
Simon, Roger MD*<br />
DeKalb County<br />
303 Parkway Dr NE Ste 102<br />
80 Jesse Hill Jr Dr Atlanta, GA 30312 Stone Mountain, GA<br />
Atlanta, GA 30303 Gullick, Richard MD* 404-265-4565<br />
30087<br />
404-616-5800 2675 N Decatur Rd 770-469-9961<br />
Ste 710<br />
Gwinnett County<br />
Thrower, Ben*<br />
Decatur, GA 30033<br />
Brown, Pamela*<br />
2020 Peachtree Rd NE Mulick, Arthur*<br />
404-299-3338<br />
2801 N Decatur Rd<br />
Atlanta, GA 30309<br />
481 West Pike Street<br />
Ste 190<br />
404-352-2020 Lawrenceville, GA 30045<br />
Decatur, GA 30033<br />
678-376-3550<br />
404-299-9307<br />
Page 44<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Obstetrics & Carmichael, Stephanie* Dourron, Rodney MD* Garrett, Veronica MD*<br />
Gynecology cont. 2701 N Decatur Rd 440 Winn Way 5910 Hillandale Dr Ste<br />
Decatur, GA 30033 Decatur, GA 30030 205<br />
DeKalb County 404-501-5422 404-294-3895 Lithonia, GA 30058<br />
cont. 678-413-0858<br />
Carmichael, Stephanie* Dourron, Rodney MD*<br />
Burgin, Janice* 2701 N Decatur Rd 4961 Buford Hwy Glasser, Gary*<br />
2675 N Decatur Rd Decatur, GA 30033 Ste 202 315 Winn Way<br />
Suite 512 404-501-7925 Atlanta, GA 30341 Decatur, GA 30030<br />
Decatur, GA 30033 770-458-7074 404-299-9724<br />
404-508-2000<br />
Crenshaw, Yvonka MD*<br />
2675 North Decatur Road Entrekin, Kay* Goodman, Cynthia*<br />
Burgin, Janice* Ste 604 315 Winn Way 1836 Second Ave<br />
2675 N Decatur Rd Decatur, GA 30033 Decatur, GA 30030 Decatur, GA 30032<br />
Ste 512 678-904-1150 404-299-9724 404-874-4848<br />
Decatur, GA 30033<br />
404-508-2000<br />
Dourron, Robert MD* Fine, Mindy* Henson, Chelsea NP*<br />
2277 S Stone Mountain 3114 Mercer University 2665 N Decatur Rd<br />
Burgin, Janice* Lithonia Rd Dr Ste 100 Ste 750<br />
8052 Mall Pkwy Lithonia, GA 30058 Atlanta, GA 30341 Decatur, GA 30033<br />
Suite 202 770-484-2602 770-454-8080 404-501-2100<br />
Lithonia, GA 30038<br />
404-508-2000<br />
Dourron, Robert MD* Frederick, Hughan MD* Johnson, Caryn*<br />
2675 N Decatur Rd 4166 Buford Hwy 2675 N Decatur Rd<br />
Callaway, Juaquita MD* Ste 301 Suite 1029 Ste 512<br />
2785 Lawrenceville Hwy Decatur, GA 30030 Atlanta, GA 30345 Decatur, GA 30033<br />
Ste 107 404-294-0472 404-417-9360 404-508-2000<br />
Decatur, GA 30033<br />
678-205-0405<br />
Dourron, Robert MD* Gamble, Kendra* Kobe, Elizabeth*<br />
3110 Clifton Springs Rd 1805 Parke Plaza Cir 1462 Montreal Rd<br />
Carmichael, Stephanie* Ste D Ste 102 Ste 412<br />
1462 Montreal Rd Decatur, GA 30034 Stone Mountain, GA Tucker, GA 30084<br />
Ste 412 404-224-2235 30087 770-493-9191<br />
Tucker, GA 30084 770-469-9961<br />
770-493-9191<br />
Dourron, Robert MD*<br />
Levitt, Brian*<br />
440 Winn Way Gamble, Kendra* 2675 N Decatur Rd<br />
Carmichael, Stephanie* Decatur, GA 30030 2801 N Decatur Rd Ste G05<br />
2701 N Decatur Rd 404-294-3895 Ste 190 Decatur, GA 30033<br />
Decatur, GA 30033 Decatur, GA 30033 678-904-7210<br />
404-501-5422 Dourron, Robert* 404-299-9307<br />
4961 Buford Hwy Levitt, Brian*<br />
Carmichael, Stephanie* Ste 202 Gamble, Kendra* 2685 Milscott Dr<br />
2701 N Decatur Rd Atlanta, GA 30341 2801 North Decatur Rd Decatur, GA 30033<br />
Decatur, GA 30033 770-458-7074 Ste 190 678-904-7210<br />
404-501-7925 Decatur, GA 30033<br />
Dourron, Rodney MD* 404-299-9307<br />
Lyman, Jennifer*<br />
Carmichael, Stephanie* 2277 S Stone Mountain 315 Winn Way<br />
2701 N Decatur Rd Lithonia Rd Garrett, Veronica MD* Decatur, GA 30030<br />
Decatur, GA 30033 Lithonia, GA 30058 2801 DeKalb Medical 404-299-9724<br />
404-501-5422 770-484-2602 Pkwy<br />
Lithonia, GA 30058 Mandeville, Lisa*<br />
Carmichael, Stephanie* Dourron, Rodney MD* 678-526-0292<br />
315 Winn Way<br />
2701 N Decatur Rd 3110 Clifton Springs Rd Decatur, GA 30030<br />
Decatur, GA 30033 Ste D 404-299-9724<br />
404-501-7925 Decatur, GA 30034<br />
404-224-2235<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 45<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Obstetrics & Roberts, James MD* Thomas Burse, Janella* Bent-Harley, Sharon<br />
Gynecology cont. 5411 Memorial Drive 770 Village Square Drive MD*<br />
Stone Mountain, GA Stone Mountain, GA 1800 Peachtree St Nw<br />
DeKalb County 30083 30083 Ste 450<br />
cont. 404-508-8133 404-298-8998 Atlanta, GA 30309<br />
678-904-5999<br />
Meyer-Carper, Jennifer* Ross, Shalandra* Tucker, George MD*<br />
315 Winn Way 1760 Candler Rd 3523 Budford Hwy Bills, Elbridge MD*<br />
Decatur, GA 30030 Decatur, GA 30032 Ste 100 3400 Old Milton Pkwy<br />
404-299-9724 404-286-2215 Atlanta, GA 30329 Suite 425<br />
404-634-4550 Alpharetta, GA 30005<br />
Naiden, Vintonne* Ross, Shalandra* 770-777-4933<br />
3951 Snapfinger PKWY 770 Village Square Drive Fulton County<br />
STE 350 Stone Mountain, GA Bills, Elbridge MD*<br />
Decatur, GA 30035 30083 Anachebe, Ngozi MD* 5670 Peachtree<br />
770-449-9334 404-298-8998 75 Piedmont Ave NE Dunwoody Rd NE<br />
Ste 700 Ste 1240<br />
Pancer, Stuart* Schneider, Julie* Atlanta, GA 30303 Atlanta, GA 30342<br />
1462 Montreal Rd 315 Winn Way 404-756-1410 770-777-4933<br />
Ste 412 Decatur, GA 30030<br />
Tucker, GA 30084 404-299-9724 Anachebe, Ngozi MD* Borders, Juel MD*<br />
770-493-9191 809 Cleveland Ave Sw 991 Martin Luther King Jr<br />
Scott, Albert* Atlanta, GA 30315 Dr<br />
Pancer, Stuart* 2675 N Decatur Rd 404-767-2536 Atlanta, GA 30314<br />
2701 N Decatur Rd Ste 512 404-758-2192<br />
Decatur, GA 30033 Decatur, GA 30033 Assevero, Michael*<br />
404-501-5422 404-508-2000 3699 Bakers Ferry Rd SW Braswell, Precious MD*<br />
Atlanta, GA 30337 1920 John Wesley Ave<br />
Pope, Leslie* Scott, Albert* 404-765-4164 Atlanta, GA 30337<br />
1462 Montreal Rd 2801 DeKalb Medical 770-513-4000<br />
Ste 412<br />
Pkwy<br />
Assevero, Michael*<br />
Tucker, GA 30084 Lithonia, GA 30058 936 Holcomb Bridge Rd Braswell, Precious MD*<br />
770-493-9191 404-501-8000 Roswell, GA 30076 2885 Headland Drive<br />
770-992-3777 East Point, GA 30344<br />
Pope, Leslie* Scott, Albert* 404-349-5600<br />
2701 N Decatur Rd 5900 Hillandale Dr Assevero, Michael*<br />
Decatur, GA 30033 Ste 200 Clincia De La Mama Brummitt, Kenyetta*<br />
404-501-5422 Lithonia, GA 30058 Rosewell<br />
303 Parkway Dr Ne<br />
404-508-2000 936 Holcomb Bridge Atlanta, GA 30312<br />
Raynor, B Denise MD* Road 404-265-4000<br />
2665 N Decatur Road Stewart, Lynette MD* Roswell, GA 30076<br />
Suite 710 3660 Flat Shoals Rd 770-992-3777<br />
Brummitt, Kenyetta*<br />
Decatur, GA 30033 Decatur, GA 30034 550 Peachtree St Ne<br />
404-299-7712 404-243-7777 Becker, Nadine* Atlanta, GA 30308<br />
1015 Mansell Road 404-767-2536<br />
Reynolds, Stacy MD* Sutton, Madeline MD* Roswell, GA 30076<br />
2675 North Decatur Road 1760 Candler Rd 678-352-0254<br />
Bruscato, Eliza*<br />
Ste 512 Decatur, GA 30032 3020 Paces Mill Road<br />
Decatur, GA 30033 404-286-2215 Benson, Elinor MD* Ste 225<br />
404-508-2000 991 Martin Luther King Jr Atlanta, GA 30339<br />
Sutton, Madeline MD* Dr 404-256-4144<br />
Reynolds, Stacy MD* 770 Village Square Dr Atlanta, GA 30314<br />
8052 Mall Parkway Ste Stone Mountain, GA 404-758-2192<br />
Bruscato, Eliza*<br />
202 30083 960 Johnson Ferry Road<br />
Lithonia, GA 30038 404-286-2215 Ste 215<br />
404-508-2000 Atlanta, GA 30342<br />
404-256-4144<br />
Page 46<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Obstetrics & Diamond, Ivan* Franklin, Cheryl MD* Kayler, Amy CNM*<br />
Gynecology cont. 1000 Johnson Ferry Rd 75 Piedmont Avenue 1000 Johnson Ferry Rd<br />
NE Ste 700 NE<br />
Fulton County cont. Atlanta, GA 30342 Atlanta, GA 30303 Atlanta, GA 30342<br />
404-256-8000 404-756-1400 404-851-8988<br />
Burton, Charles MD*<br />
1587 Phoenix Blvd Ste 6 Diamond, Ivan* Frederick, Hughan MD* Kayler, Amy CNM*<br />
Atlanta, GA 30349 1015 Mansell Rd 401 S Main St 1015 Mansell Road<br />
770-994-6806<br />
Roswell, GA 30076 Alpharetta, GA 30004 Roswell, GA 30076<br />
678-352-0254 770-521-2229 678-352-0254<br />
Charlton, Julie CNM*<br />
1000 Johnson Ferry Rd Diamond, Ivan* Frederick, Hughan MD* Kayler, Amy CNM*<br />
NE<br />
980 Johnson Ferry Rd Ne 936 Holcomb Bridge Rd 3000 Hospital Blvd<br />
Atlanta, GA 30342 Suite 660 Roswell, GA 30076 Roswell, GA 30076<br />
404-851-8988<br />
Atlanta, GA 30342 770-613-0070 770-751-2509<br />
404-255-2057<br />
Charlton, Julie CNM*<br />
Guercio, Cynthia CNM* Kayler, Amy CNM*<br />
3000 Hospital Blvd Dott, Andrew MD* 340 Boulevard NE 980 Johnson Ferry Road<br />
Roswell, GA 30076 993 D Johnson Ferry Rd Suite 103 Ste 660<br />
770-751-2509<br />
Ste 360 Atlanta, GA 30312 Atlanta, GA 30342<br />
Atlanta, GA 30342 404-223-2229 404-255-2057<br />
Charlton, Julie CNM* 404-250-9309<br />
6325 Hospital Parkway<br />
Hajjaji, Sarah CNM* Korotkin, Jeffrey*<br />
Duluth, GA 30097 Fielder, Judy CNM* 1920 John Wesley 1000 Johnson Ferry Rd<br />
678-474-7000<br />
1000 Johnson Ferry Rd Avenue Ne Dept 652<br />
NE College Park, GA 30337 Atlanta, GA 30342<br />
Charlton, Julie CNM* Atlanta, GA 30342 404-765-4185 404-851-8988<br />
6325 W Johns Crossing 404-851-8988<br />
Bldg 100, Ste 209<br />
Hajjaji, Sarah CNM* Korotkin, Jeffrey*<br />
Duluth, GA 30097 Fielder, Judy CNM* 6335 Hospital Parkway 11975 Morris Rd<br />
678-805-2246<br />
1015 Mansell Road Ste 210 Ste 130<br />
Roswell, GA 30076 Johns Creek, GA 30097 Alpharetta, GA 30005<br />
Charlton, Julie CNM* 678-352-0254 770-622-5889 404-851-8788<br />
980 Johnson Ferry Road<br />
Ste 660<br />
Fielder, Judy CNM* Hardtman, Pandora Korotkin, Jeffrey*<br />
Atlanta, GA 30342 980 Johnson Ferry Road CNM* 3400 Old Milton Pkwy<br />
404-255-2057<br />
Suite 620 340 Boulevard NE Ste 185<br />
Atlanta, GA 30342 Suite 103 Alpharetta, GA 30005<br />
Crenshaw, Yvonka MD* 404-255-2057 Atlanta, GA 30312 404-851-8788<br />
550 Peachtree St Ne Ste 404-223-2229<br />
1060<br />
Ford, Marsha CNM*<br />
Korotkin, Jeffrey*<br />
Atlanta, GA 30308 2719 Felton Dr Henderson, Zsakeba 77 Collier Rd NW<br />
404-581-0307<br />
Ste A MD* Ste 1330<br />
Atlanta, GA 30344 75 Piedmont Rd Atlanta, GA 30309<br />
Cunningham, Kirstie 404-349-2112 Ste 700 404-351-3574<br />
MD* Atlanta, GA 30303<br />
6335 Hospital Parkway Ford, Marsha CNM* 404-756-1480<br />
Lemon, Tracey MD*<br />
Ste 210<br />
2719 Felton Dr 285 Boulevard NE<br />
Johns Creek, GA 30097 Ste A Henderson, Zsakeba Ste 410<br />
770-622-5889<br />
Atlanta, GA 30344 MD* Atlanta, GA 30312<br />
404-349-2112 80 Jesse Hill Jr Dr 404-265-6888<br />
Dawson, Felicia* Atlanta, GA 30303<br />
1 Baltimore Pl Nw Ste Ford, Marsha CNM* 404-616-5800<br />
Lemon, Tracey MD*<br />
350<br />
340 Blvd NE 315 Boulevard NE<br />
Atlanta, GA 30308 Atlanta, GA 30312 Ste 328<br />
404-733-6334<br />
404-223-2229 Atlanta, GA 30312<br />
404-265-6888<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 47<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Obstetrics & Modugno, Robert MD* Robinowitz, Michael Saltzman, Steven MD*<br />
Gynecology cont. 6335 Hospital Parkway MD* 265 Boulevard NE<br />
Ste 210 1587 Phoenix Blvd 2nd floor<br />
Fulton County cont. Johns Creek, GA 30097 Ste 6 Atlanta, GA 30312<br />
770-622-5889 Atlanta, GA 30349 404-265-4940<br />
Lemon, Tracey MD* 770-994-6806<br />
35 Linden Ave<br />
Montgomery-Rice,<br />
Saltzman, Steven MD*<br />
Atlanta, GA 30308 Valerie MD* Saint Louis, Hedwige* 285 Boulevard NE<br />
404-265-3154<br />
75 Piedmont Avenue 1015 Mansell Road Ste 520<br />
Ste 700 Roswell, GA 30076 Atlanta, GA 30312<br />
Lipscomb-McDaniel, Atlanta, GA 30303 678-352-0254 404-265-2800<br />
Kim MD* 404-756-1410<br />
980 Johnson Ferry Road<br />
Saint Louis, Hedwige Sermons, Alvin MD*<br />
Ste 660<br />
Montgomery-Rice, MD* 1829 Independence Sq<br />
Atlanta, GA 30342 Valerie MD* 1015 Mansell Road Ste 1<br />
404-255-2057<br />
80 Jesse Hill Jr Drive SE Roswell, GA 30076 Atlanta, GA 30338<br />
Atlanta, GA 30303 678-352-0254 770-551-9616<br />
Marder, Sara MD* 404-616-7578<br />
1000 Johnson Ferry Rd<br />
Saint Louis, Hedwige* Siegel, Garry MD*<br />
NE<br />
Olubuyide, Temitope 6325 W Johns Crossing 1295 Hembree Raod<br />
Atlanta, GA 30342 MD* Bldg 100, Ste 209 Bldg B, Suite 203<br />
404-256-8000<br />
550 Peachtree St Ne Ste Duluth, GA 30097 Roswell, GA 30076-7013<br />
1060 678-805-2246 770-664-7013<br />
Marder, Sara MD* Atlanta, GA 30308<br />
6335 Hospital Parkway 404-581-0307<br />
Saint Louis, Hedwige Simmons, Lorenza MD*<br />
Ste 209<br />
MD*<br />
315 Boulevard NE<br />
Duluth, GA 30097 Pattillo, Roland MD* 6325 W Johns Crossing Ste 336<br />
404-255-2057<br />
75 Piedmont Ave NE Bldg 100, Ste 209 Atlanta, GA 30312<br />
Ste 700 Duluth, GA 30097 404-522-4888<br />
Marder, Sara MD* Atlanta, GA 30303 678-805-2246<br />
980 Johnson Ferry Rd Ne 404-756-1410<br />
Simmons, Lorenza MD*<br />
Suite 660<br />
Saint Louis, Hedwige* 6285 Shannon Pkwy<br />
Atlanta, GA 30342 Phillips, Kiwita MD* 75 Piedmont Avenue Union City, GA 30291<br />
404-255-2057<br />
1595 W Cleveland Ste 700 770-964-4142<br />
Avenue Atlanta, GA 30303<br />
Martin, Michelle MD* East Point, GA 30344 404-756-1410<br />
Smith, Gary MD*<br />
550 Peachtree St Ne Ste 404-616-2886<br />
3400 Old Milton Pkwy<br />
1250<br />
Saint Louis, Hedwige Ste 340<br />
Atlanta, GA 30308 Phillips, Kiwita MD* MD* Alpharetta, GA 30005<br />
770-434-3800<br />
75 Piedmont Ave 75 Piedmont Avenue 770-565-4224<br />
Ste 700 Ste 700<br />
McBrayer Sr, Daniel* Atlanta, GA 30303 Atlanta, GA 30303 St Julian, Tracey MD*<br />
285 Boulevard Ne Ste 404-756-1400 404-756-1410<br />
3699 Bakers Ferry Rd SW<br />
240<br />
Atlanta, GA 30337<br />
Atlanta, GA 30312 Phillips, Kiwita MD* Saint Louis, Hedwige* 404-765-4164<br />
404-584-8428<br />
80 Jesse Hill Jr Dr 980 Johnson Ferry Road<br />
Atlanta, GA 30303 Suite 620<br />
Tandy, Diane CNM*<br />
Modugno, Robert MD* 404-616-1415 Atlanta, GA 30342 2500 Hospital Blvd<br />
2500 Hospital Blvd 404-255-2057<br />
Suite 290<br />
Suite 290<br />
Raynor, B Denise MD* Roswell, GA 30076<br />
Roswell, GA 30076 1136 Cleveland Ave Saint Louis, Hedwige 770-622-5889<br />
770-622-5889<br />
Suite 118<br />
MD*<br />
Atlanta, GA 30344 980 Johnson Ferry Road Tandy, Diane CNM*<br />
404-767-6181 Suite 620<br />
6335 Hospital Parkway<br />
Atlanta, GA 30342 Ste 210<br />
404-255-2057<br />
Johns Creek, GA 30097<br />
770-622-5889<br />
Page 48<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Obstetrics & Wetter, Amy MD* Ball Lupa, Julia* Frederick, Hughan MD*<br />
Gynecology cont. 980 Johnson Ferry Road 500 Medical Center Blvd 5127 Jimmy Carter Blvd<br />
Suite 620 Ste 290 Norcross, GA 30093<br />
Fulton County cont. Atlanta, GA 30342 Lawrenceville, GA 30045 770-613-0070<br />
404-255-2057 770-962-5100<br />
Thomas Burse, Janella*<br />
Gerber, Alan MD*<br />
1720 Phoenix Blvd Yowler, Deena CNM* Bonk, Catherine* 2069 Teron Trace<br />
Ste 700<br />
1000 Johnson Ferry Rd 449 Pleasant Hill Rd Nw Ste 300<br />
Atlanta, GA 30349 NE Ste 200 Dacula, GA 30019<br />
404-446-4792<br />
Atlanta, GA 30342 Lilburn, GA 30047 678-541-2001<br />
404-851-8988 770-923-5033<br />
Tucker, G*<br />
Gerber, Alan MD*<br />
3699 Cascade Rd Yowler, Deena CNM* Campbell, Mary MD* 3635 Braselton Hwy<br />
Ste A<br />
1015 Mansell Road 1700 Tree Ln Ste B-1<br />
Atlanta, GA 30331 Roswell, GA 30076 Ste 290 Dacula, GA 30019<br />
404-699-2400<br />
678-352-0254 Snellville, GA 30078 678-541-2001<br />
770-972-0330<br />
Tucker, George MD* Yowler, Deena CNM*<br />
Glasser, Gary*<br />
265 Boulevard NE 3000 Hospital Blvd Carmichael, Stephanie* 449 Pleasant Hill Rd NW<br />
2nd floor<br />
Roswell, GA 30076 4120 Five Forks Trickum Ste 200<br />
Atlanta, GA 30312 770-751-2509 Rd Sw Lilburn, GA 30047<br />
404-265-4940<br />
Ste 103 770-923-5033<br />
Yowler, Deena CNM* Lilburn, GA 30047<br />
Weinstein, Lawrence 6325 Hospital Parkway 770-396-2496<br />
Glasser, Gary*<br />
MD*<br />
Duluth, GA 30097<br />
449 Pleasant Hill Rd Nw<br />
1000 Johnson Ferry Rd 678-474-7000 Carter, Ursula* Ste 200<br />
NE<br />
500 Medical Center Blvd Lilburn, GA 30047<br />
Atlanta, GA 30342 Yowler, Deena CNM* Ste 290 770-923-5033<br />
404-851-8988<br />
980 Johnson Ferry Road Lawrenceville, GA 30045<br />
Ste 660<br />
770-962-5100<br />
Griffin, Kerry*<br />
Weinstein, Lawrence Atlanta, GA 30342<br />
1000 Medical Center Blvd<br />
MD*<br />
404-255-2057 Charlton, Julie CNM* Lawrenceville, GA 30046<br />
1015 Mansell Road<br />
1000 Medical Center Blvd 678-312-4616<br />
Roswell, GA 30076 Zimmermann, Julie* Lawrenceville, GA 30045<br />
678-352-0254<br />
1015 Mansell Rd 678-442-4321<br />
Griffin, Kerry*<br />
Roswell, GA 30076<br />
3855 Pleasant Hill Rd<br />
Weinstein, Lawrence 678-352-0254 Charlton, Julie CNM* Ste 210<br />
MD*<br />
500 Medical Center Blvd Duluth, GA 30096<br />
980 Johnson Ferry Road Zimmermann, Julie* Ste 210 770-622-0282<br />
Suite 620<br />
6335 Hospital Parkway Lawrenceville, GA 30045<br />
Atlanta, GA 30342 Ste 209<br />
770-822-3344<br />
Hamidi, Haleh MD*<br />
404-255-2057<br />
Duluth, GA 30097<br />
1700 Tree Ln<br />
404-255-2057 Elgammal, Nahed MD* Ste 290<br />
Wetter, Amy MD*<br />
1700 Tree Lane Rd Snellville, GA 30078<br />
1015 Mansell Road Zimmermann, Julie* Ste 290 770-972-0330<br />
Roswell, GA 30076 980 Johnson Ferry Road Snellville, GA 30078<br />
678-352-0254<br />
Suite 620<br />
770-972-0330<br />
Hayles-Patterson,<br />
Atlanta, GA 30342<br />
Jacquline MD*<br />
Wetter, Amy MD* 404-255-2057 Entrekin, Kay* 2775 Cruse Rd<br />
6325 W Johns Crossing<br />
449 Pleasant Hill Rd Nw Ste 2101<br />
Bldg 100, Ste 209 Gwinnett County Ste 200 Lawrenceville, GA 30044<br />
Duluth, GA 30097<br />
Lilburn, GA 30047 678-380-1200<br />
678-805-2246<br />
Assevero, Michael*<br />
770-923-5033<br />
5127 Jimmy Carter Blvd<br />
Norcross, GA 30093<br />
770-613-0770<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 49<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Obstetrics & Kohlhagen, Laura* Mandeville, Lisa* Middleton, Courtney*<br />
Gynecology cont. 500 Medical Center Blvd 449 Pleasant Hill Rd NW 500 Medical Center Blvd<br />
Ste 290 Ste 200 Ste 290<br />
Gwinnett County Lawrenceville, GA 30045 Lilburn, GA 30047 Lawrenceville, GA 30045<br />
cont. 770-962-5100 770-923-5033 770-962-5100<br />
Hayles-Patterson, Kohlhagen, Laura* Mandeville, Lisa* Mojcik, Michael MD*<br />
Jacquline MD* 500 Medical Center Blvd 449 Pleasant Hill Rd Nw 1700 Tree Ln<br />
771 Old Norcrcss Rd Ste#250 Ste 200 Ste 290<br />
Ste 350 Lawrenceville, GA 30045 Lilburn, GA 30047 Snellville, GA 30078<br />
Lawrenceville, GA 30046 770-962-5100 770-923-5033 770-972-0330<br />
678-380-1200<br />
Korotkin, Jeffrey* Mandeville, Lisa* Pancer, Stuart*<br />
Henson, Chelsea NP* 3890 Johns Creek Pkwy 449 Pleasant Hill Rd NW 4120 Five Forks Trickum<br />
1800 Tree Ln Ste 250 Ste 200 Rd Sw<br />
Ste 370 Suwanee, GA 30024 Lilburn, GA 30047 Ste 103<br />
Snellville, GA 30078 404-851-8788 770-923-5033 Lilburn, GA 30047<br />
770-279-3838 770-396-2496<br />
Laremont, Sylvia* Mandeville, Lisa*<br />
Jean-Gilles, Marc* 4231 Pleasant Hill Rd 449 Pleasant Hill Rd Nw Pope, Leslie*<br />
1935 Buford Mill Dr Duluth, GA 30096 Ste 200 3025 Breckinridge Blvd<br />
Ste G 678-474-0735 Lilburn, GA 30047 Ste 120<br />
Buford, GA 30519 770-923-5033 Duluth, GA 30096<br />
678-745-0285 Levitt, Brian*<br />
770-493-9191<br />
1700 Tree Ln Manga, Mercy*<br />
Johnson, Traci MD* Ste 200 500 Medical Center Blvd Pope, Leslie*<br />
1700 Medical Way Snellville, GA 30078 Ste 290 4120 Five Forks Trickum<br />
Snellville, GA 30078 678-904-7210 Lawrenceville, GA 30045 Rd Sw<br />
770-972-0330 770-962-5100 Ste 103<br />
Lyman, Jennifer* Lilburn, GA 30047<br />
Jones, Tyndal MD* 449 Pleasant Hill Rd NW Marder, Sara MD* 770-396-2496<br />
2775 Cruse Rd Ste 200 1000 Medical Center Blvd<br />
Ste 2101 Lilburn, GA 30047 Lawrenceville, GA 30045- Saint Louis, Hedwige*<br />
Lawrenceville, GA 30044 770-923-5033 7694 500 Medical Center Blvd<br />
678-380-1200 678-312-4321 Ste 210<br />
Lyman, Jennifer* Lawrenceville, GA 30045<br />
Jones, Tyndal MD* 449 Pleasant Hill Rd Nw Marder, Sara MD* 770-822-3344<br />
771 Old Norcrcss Rd Ste 200 500 Medical Center Blvd<br />
Ste 350 Lilburn, GA 30047 Ste 210 Schneider, Julie*<br />
Lawrenceville, GA 30046 770-923-5033 Lawrenceville, GA 30046 449 Pleasant Hill Rd Nw<br />
678-380-1200 770-822-3344 Ste 200<br />
Mandeville, Lisa* Lilburn, GA 30047<br />
Kayler, Amy CNM* 449 Pleasant Hill Rd NW McKune, Kelly CNM* 770-923-5033<br />
1000 Medical Center Blvd Ste 200 1000 Medical Center<br />
Lawrenceville, GA 30045 Lilburn, GA 30047 Blvd Silberstein, Debra*<br />
678-442-4321 770-923-5033 Ste 210 3780 Holcomb Bridge Rd<br />
Lawrenceville, GA 30045 Ste C<br />
Kayler, Amy CNM* Mandeville, Lisa* 770-622-0282 Norcross, GA 30092<br />
500 Medical Center Blvd 449 Pleasant Hill Rd Nw 770-246-4446<br />
Ste 210 Ste 200 Meyer-Carper, Jennifer*<br />
Lawrenceville, GA 30045 Lilburn, GA 30047 449 Pleasant Hill Rd Sklare, Kelly*<br />
770-822-3344 770-923-5033 Ste 200 1000 Medical Center Blvd<br />
Lilburn, GA 30047 Lawrenceville, GA 30046<br />
770-923-5033 678-312-4616<br />
Page 50<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Obstetrics & Henry County Sharma, Atul* Stoltz, Robert*<br />
Gynecology cont.<br />
155 Medical Way 114 Cherry St Ne<br />
Raynor, B Denise MD* Ste E Ste F<br />
Gwinnett County<br />
255 Corporate Center Riverdale, GA 30274 Marietta, GA 30060<br />
cont. Drive<br />
770-907-9400 770-218-1888<br />
Suite B<br />
Sklare, Kelly* Stockbridge, GA 30281 Stallmann, Jay* DeKalb County<br />
3855 Pleasant Hill Rd 770-692-0344 155 Medical Way<br />
Ste 210<br />
Ste E<br />
Dew, James*<br />
Duluth, GA 30096 Rockdale County Riverdale, GA 30274 2200 Northlake Pkwy<br />
770-622-0282 770-907-9400<br />
Ste 300<br />
Raynor, B Denise MD* Tucker, GA 30084<br />
Snead, Laurie* 4368 Wellbrook Circle NE Stoltz, Robert* 770-938-1705<br />
3780 Holcomb Bridge Rd Suite A<br />
155 Medical Way<br />
Ste D<br />
Conyers, GA 30012 Ste E<br />
Jacobson, Michael*<br />
Norcross, GA 30092 770-760-7855 Riverdale, GA 30274 465 Winn Way<br />
770-246-4446 770-907-9400<br />
Ste 100<br />
Ophthalmology Decatur, GA 30030<br />
Stewart, Lynette MD* Cobb County 404-299-5209<br />
4775 Jimmy Carter Blvd Bibb County<br />
Ste 101<br />
Jacobson, Michael* Knight, Stephen*<br />
Ste 101<br />
Miller, John* 114 Cherry St Ne 1459 Montreal Rd<br />
Norcross, GA 30093 160 Water Tower Ct Ste F Ste 501<br />
770-638-8446<br />
Macon, GA 31210 Marietta, GA 30060 Tucker, GA 30084<br />
478-757-8806 770-218-1888 770-491-3700<br />
Sveum, Jonne CNM*<br />
761 Old Norcross Rd Clayton County Koh, Sean* Koh, Sean*<br />
Lawrenceville, GA 30046<br />
114 Cherry St Ne 465 Winn Way<br />
770-513-4300<br />
Jacobson, Michael* Ste F Ste 100<br />
155 Medical Way Marietta, GA 30060 Decatur, GA 30030<br />
Wetter, Amy MD* Ste E<br />
770-218-1888 404-299-5209<br />
500 Medical Center Blvd Riverdale, GA 30274<br />
Ste 210<br />
770-907-9400 Lampert, Scott* Lai, Yin-Lok MD*<br />
Lawrenceville, GA 30045<br />
114 Cherry St Ne 5069 Buford Hwy NE<br />
770-822-3344<br />
Koh, Sean* Ste F Atlanta, GA 30340<br />
155 Medical Way Marietta, GA 30060 770-451-5403<br />
Yowler, Deena CNM* Ste E<br />
770-218-1888<br />
1000 Medical Center Blvd Riverdale, GA 30274<br />
Lampert, Scott*<br />
Lawrenceville, GA 30045 770-907-9400 Rivellese, Mark* 465 Winn Way<br />
678-442-4321<br />
114 Cherry St Ne Ste 100<br />
Lampert, Scott* Ste F Decatur, GA 30030<br />
Yowler, Deena CNM* 155 Medical Way Marietta, GA 30060 404-299-5209<br />
500 Medical Center Blvd Ste E<br />
770-218-1888<br />
Ste 210<br />
Riverdale, GA 30274<br />
Leff, Stephen*<br />
Lawrenceville, GA 30045 770-907-9400 Sharma, Atul* 465 Winn Way<br />
770-822-3344<br />
114 Cherry St Ne Ste 140<br />
Miller, John* Ste F Decatur, GA 30030<br />
Zahner, Lynn MD* 155 Medical Way Marietta, GA 30060 404-298-5557<br />
337 W Pike St Ste E<br />
770-218-1888<br />
Ste A<br />
Riverdale, GA 30274<br />
Leff-Goldstein, Gayle*<br />
Lawrenceville, GA 30045 770-907-9400 Stallmann, Jay* 465 Winn Way<br />
770-339-0332<br />
114 Cherry St Ne Ste 140<br />
Rivellese, Mark* Ste F Decatur, GA 30030<br />
155 Medical Way Marietta, GA 30060 404-298-5557<br />
Ste E 770-218-1888<br />
Riverdale, GA 30274<br />
770-907-9400<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 51<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Ophthalmology Stoltz, Robert* Brody, Jason MD* Lampert, Scott*<br />
cont. 465 Winn Way 800 Mt Vernon Hwy 5671 Peachtree<br />
Ste 100 Ste 100 Dunwoody Rd Ne<br />
DeKalb County Decatur, GA 30030 Atlanta, GA 30328 Ste 610<br />
cont. 404-299-5209 404-256-1125 Atlanta, GA 30342<br />
Rivellese, Mark*<br />
404-255-9096<br />
Wang, Zhengxiang* Cole, Harvey MD*<br />
2701 N Decatur Rd<br />
5150 Buford Highway 5505 Peachtree Leff, Steven MD*<br />
Decatur, GA 30033<br />
Ste A220 Dunwoody Rd Ne 1800 Phoenix Blvd<br />
404-501-5422<br />
Doraville, GA 30340 Ste 640 Ste 406<br />
Rivellese, Mark* 770-457-0012 Atlanta, GA 30342 Atlanta, GA 30349<br />
465 Winn Way<br />
404-256-1500 770-996-6664<br />
Ste 100<br />
Douglas County<br />
D’heurle, David MD* Leff, Steven MD*<br />
Decatur, GA 30030 Miller, John* 1720 Peachstreet Street 5505 Peachtree<br />
404-299-5209 6095 Professional Pkwy Ste 932 Dunwoody Rd NE<br />
Safra, Mark*<br />
Ste B202 Atlanta, GA 30309 Ste 300<br />
2910 N Druid Hills Rd Ne<br />
Douglasville, GA 30134 404-351-0590 Atlanta, GA 30342<br />
Ste M<br />
678-303-0136 404-257-0814<br />
Freeman, Kevin MD*<br />
Atlanta, GA 30329 Fulton County 2180 Satellite Blvd Marmer, Robert MD*<br />
404-633-0606<br />
Ste 400<br />
777 Cleveland Ave SW<br />
Beldick, Gary MD*<br />
Seward, Clifford* Duluth, GA 30097 Ste 102<br />
2645 Donald Lee<br />
5900 Hillandale Dr Ste 770-239-1755 Atlanta, GA 30315<br />
Hollowell Pkwy Nw<br />
345 404-768-2020<br />
Atlanta, GA 30318 Hays, James MD*<br />
Lithonia, GA 30058 404-794-0014 3200 Downwood Cir Nw Matzkin, Dennis MD*<br />
678-990-4480<br />
Ste 240<br />
10080 Medlock Bridge<br />
Beldick, Gary MD*<br />
Sharma, Atul* Atlanta, GA 30327 Road<br />
5669 Peachtree<br />
465 Winn Way 404-351-1990 Duluth, GA 30097<br />
Dunwoody Rd Ne<br />
Ste 100 770-623-3931<br />
Ste 202 Hays, James MD*<br />
Decatur, GA 30030 Atlanta, GA 30328 800 Mt Vernon Hwy Miller, John*<br />
404-299-5209 404-252-5458 Ste 100 5671 Peachtree<br />
Silverman, Stuart MD* Atlanta, GA 30328 Dunwoody Rd Ne<br />
Bordenca, Mark*<br />
5243 Snapfinger Woods 404-256-1125 Ste 610<br />
5445 Meridian Mark Rd<br />
Dr Atlanta, GA 30342<br />
Ste 220 Jacobson, Michael*<br />
Decatur, GA 30035 404-255-9096<br />
Atlanta, GA 30342 5671 Peachtree<br />
770-981-9010 404-255-2419 Dunwoody Rd Ne Murphy, Brent MD*<br />
Stallmann, Jay* Ste 610<br />
5505 Peachtree<br />
Brody, Jason MD*<br />
465 Winn Way Atlanta, GA 30342 Dunwoody Rd Ne<br />
10775 Alpharetta Hwy<br />
Ste 100 404-255-9096 Ste 640<br />
Roswell, GA 30076<br />
Decatur, GA 30030 Atlanta, GA 30342<br />
866-527-3722 Koh, Sean*<br />
404-299-5209<br />
404-256-1500<br />
3280 Howell Mill Road<br />
Brody, Jason MD*<br />
Stephens, Augustus NW Newman, Stuart MD*<br />
800 Mt Vernon Hwy<br />
MD* Ste 304 1169 Alpharetta St<br />
Ste 125<br />
5243 Snapfinger Woods Atlanta, GA 30342 Roswell, GA 30076<br />
Atlanta, GA 30328<br />
Dr 404-351-9668 678-892-2020<br />
404-237-1700<br />
Decatur, GA 30035<br />
Koh, Sean*<br />
Rivellese, Mark*<br />
770-981-9010 Brody, Jason MD* 5671 Peachtree 5671 Peachtree<br />
800 Mt Vernon Hwy Dunwoody Rd Ne Dunwoody Rd Ne<br />
Ste 120 Ste 610 Ste 610<br />
Atlanta, GA 30328 Atlanta, GA 30342 Atlanta, GA 30342<br />
770-804-1684 404-255-9096 404-255-9096<br />
Page 52<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Ophthalmology<br />
cont.<br />
Stoltz, Robert*<br />
5671 Peachtree<br />
Woolfson, Jonathan<br />
MD*<br />
Pham, Truc MD*<br />
3985 Steve Reynolds<br />
Fulton County cont.<br />
Dunwoody Rd Ne<br />
Ste 610<br />
10775 Alpharetta Hwy<br />
Roswell, GA 30076<br />
Blvd<br />
Ste K-102<br />
Shah, Anand MD*<br />
Atlanta, GA 30342 866-527-3722 Norcross, GA 30093<br />
10775 Alpharetta Hwy<br />
404-255-9096 678-367-0390<br />
Gwinnett County<br />
Roswell, GA 30076 Stulting, Robert MD* Rivellese, Mark*<br />
866-527-3722 10775 Alpharetta Hwy Bordenca, Mark* 575 Professional Dr<br />
Roswell, GA 30076 2660 Satellite Blvd<br />
Shah, Anand MD*<br />
Ste 330<br />
866-527-3722 Duluth, GA 30096<br />
800 Mt Vernon Hwy<br />
Lawrenceville, GA 30045<br />
404-255-2419<br />
Ste 125<br />
678-405-0922<br />
Stulting, Robert MD*<br />
Atlanta, GA 30328 800 Mt Vernon Hwy Brody, Jason MD* Shah, Anand MD*<br />
404-237-1700 Ste 125<br />
1980 Riverside Pkwy 1980 Riverside Pkwy<br />
Atlanta, GA 30328 Ste 103<br />
Shah, Anand MD*<br />
Ste 103<br />
404-237-1700 Lawrenceville, GA 30043<br />
800 Mt Vernon Hwy<br />
Lawrenceville, GA 30043<br />
770-407-0029<br />
Ste 120<br />
770-407-0029<br />
Stulting, Robert MD*<br />
Atlanta, GA 30328 800 Mt Vernon Hwy Carlin, David MD* Sharma, Atul*<br />
770-804-1684 Ste 130<br />
2377 Lenora Church 575 Professional Dr<br />
Atlanta, GA 30328 Road<br />
Shah, Anand MD*<br />
Ste 330<br />
404-237-1770 Snellville, GA 30078<br />
800 Mt Vernon Hwy<br />
Lawrenceville, GA 30045<br />
770-979-2020<br />
Ste 100<br />
678-405-0922<br />
Stulting, Robert MD*<br />
Atlanta, GA 30328 800 Mt Vernon Hwy Derosa, Michael MD* Stallmann, Jay*<br />
404-256-1125 Ste 120<br />
2347 Lenora Church Rd 575 Professional Dr<br />
Atlanta, GA 30328 Snellville, GA 30078<br />
Sharma, Atul*<br />
Ste 330<br />
770-804-1684 770-979-2020<br />
1100 Johnson Ferry Rd<br />
Lawrenceville, GA 30045<br />
NE BLDG 2 Suite 593<br />
678-405-0922<br />
Stulting, Robert MD* Koh, Sean*<br />
Atlanta, GA 30342 800 Mt Vernon Hwy 575 Professional Dr Stoltz, Robert*<br />
404-255-9096 Ste 100<br />
Ste 330<br />
575 Professional Dr<br />
Atlanta, GA 30328 Lawrenceville, GA 30045<br />
Sharma, Atul*<br />
Ste 330<br />
404-256-1125 678-405-0922<br />
5671 Peachtree<br />
Lawrenceville, GA 30045<br />
Dunwoody Rd Ne<br />
678-405-0922<br />
Vanderveldt, Stephanie* Lampert, Scott*<br />
Ste 610<br />
1100 Johnson Ferry 575 Professional Dr Stulting, Robert MD*<br />
Atlanta, GA 30342 Road, NE<br />
Ste 330<br />
1980 Riverside Pkwy<br />
404-255-9096 Building 2 Suite 593 Lawrenceville, GA 30045 Ste 103<br />
Atlanta, GA 30342 678-405-0922<br />
Stallmann, Jay*<br />
Lawrenceville, GA 30043<br />
5671 Peachtree<br />
404-508-4008 770-407-0029<br />
Leff, Stephen*<br />
Dunwoody Rd Ne Weeks, Christina* 1700 Tree Ln<br />
Vanderveldt, Stephanie*<br />
Ste 610 5775 Peachtree Ste 135<br />
575 Professional Dr<br />
Atlanta, GA 30342 Dunwoody Rd Ne Snellville, GA 30078 Ste 330<br />
404-255-9096 Ste D175 770-736-7020<br />
Lawrenceville, GA 30045<br />
Stephens, Augustus<br />
Atlanta, GA 30342 678-405-0922<br />
404-303-8884<br />
Leff-Goldstein, Gayle*<br />
MD* 1700 Tree Ln Woolfson, Jonathan<br />
285 Boulevard Wilson, Carmen* Ste 135<br />
MD*<br />
Ste 540 75 Piedmont Ave NE Snellville, GA 30078 1980 Riverside Pkwy<br />
Atlanta, GA 30312 Ste 700 770-736-7020<br />
Ste 103<br />
404-582-0096 Atlanta, GA 30303 Lawrenceville, GA 30043<br />
404-756-1410 770-407-0029<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 53<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Oral &<br />
Schlatterer, Daniel MD* Gwinnett County Diamond, Andrew MD*<br />
Maxiofacial 265 Boulevard NE 11685 Alpharetta Hwy<br />
2nd floor Cooper, Donna PA-C*<br />
Surgery<br />
Ste 300<br />
Atlanta, GA 30312 545 Old Norcross Rd Roswell, GA 30076<br />
404-265-4940 Ste 300<br />
Fulton County<br />
770-475-3361<br />
Lawrenceville, GA 30045<br />
Anderson, James* Schlatterer, Daniel MD* 770-963-6300 Diamond, Andrew MD*<br />
4721 Chamblee 285 Boulevard NE 5445 Meridian Marks Rd<br />
Ste 120A<br />
Levengood, Gary MD*<br />
Dunwoody<br />
Ne<br />
Atlanta, GA 30312 1900 Riverside Parkway<br />
Dunwoody, GA 30338<br />
Atlanta, GA 30392<br />
404-265-6997 Lawrenceville, GA 30043<br />
770-396-8860<br />
404-252-5196<br />
770-237-3475<br />
Spiegl, Paul*<br />
Fortson, James MD*<br />
Orthopedic 5673 Peachtree Marsh, Nathan PA-C* 1136 Cleveland Ave<br />
Surgery<br />
Dunwoody Rd Ne 545 Old Norcross Road Ste 611<br />
Atlanta, GA 30342 Lawrenceville, GA 30045 Atlanta, GA 30344<br />
DeKalb County<br />
404-255-5595 770-963-6300<br />
404-768-9350<br />
Conduah, Augustine<br />
Gwinnett County Otolaryngology Fortson, James MD*<br />
MD*<br />
2788 Bayard Street<br />
8225 Mall Parkway Mathers, Michael MD* DeKalb County Ste 100<br />
Suite 150 545 Old Norcross Rd East Point, GA 30344<br />
Lithonia, GA 30058-7103 Ste 300 Alexander, Joel*<br />
404-768-9350<br />
770-482-3241 Lawrenceville, GA 30045 2726 Lawrenceville Hwy<br />
770-963-6300<br />
Decatur, GA 30033 Fortson, James MD*<br />
Newfield, Daren MD* 770-414-1130 285 Boulevard NE<br />
1014 Sycamore Dr Mines, Craig MD* Ste 415<br />
Ste B<br />
2121 Fountain Dr Leslie, Yvette*<br />
Atlanta, GA 30312<br />
Decatur, GA 30030 Ste E 5900 Hillandale Dr<br />
404-659-2272<br />
404-299-1700 Snellville, GA 30078 Ste 325B<br />
770-978-1422<br />
Lithonia, GA 30058 French, James MD*<br />
Fulton County 770-593-3328 2365 Old Milton Pkwy<br />
Scales, Darrell MD*<br />
Apple, David*<br />
Ste 300<br />
545 Old Norcross Rd Lieberman, Richard<br />
2020 Peachtree Rd NE<br />
Alpharetta, GA 30009<br />
Ste 300 MD*<br />
Atlanta, GA 30309<br />
770-740-1860<br />
Lawrenceville, GA 30045 2175 Northlake Pkwy<br />
404-352-2020<br />
770-963-6300<br />
Bldg 4 French, James MD*<br />
Ste 137<br />
Harris, Robert*<br />
6916 Mcginnis Ferry Rd<br />
Muscogee County Tucker, GA 30084<br />
265 Boulevard NE<br />
Ste 100<br />
770-934-4150<br />
2nd floor<br />
Duluth, GA 30097<br />
Conduah, Augustine<br />
Atlanta, GA 30312<br />
770-740-1860<br />
MD* Fulton County<br />
404-265-4940 6262 Veterans Pkwy Gallups, Jeffrey MD*<br />
Columbus, GA 31908 Beaty, Mark MD*<br />
Newfield, Daren MD*<br />
2365 Old Milton Pkwy<br />
706-324-6661 2365 Old Milton Pkwy<br />
755 Mount Vernon Hwy<br />
Ste 300<br />
Ste 300<br />
Ne Ste 370<br />
Alpharetta, GA 30009<br />
Orthopedics Alpharetta, GA 30009<br />
Atlanta, GA 30318<br />
770-740-1860<br />
770-740-1860<br />
404-845-0777 Fulton County Gallups, Jeffrey MD*<br />
Beaty, Mark MD*<br />
Newfield, Daren MD*<br />
6916 Mcginnis Ferry Rd<br />
Gibbert, Tiffany PA-C* 6916 Mcginnis Ferry Rd<br />
933 C Johnson Ferry Rd<br />
Ste 100<br />
285 Boulevard NE Ste 100<br />
Atlanta, GA 30342<br />
Duluth, GA 30097<br />
Ste 120A Duluth, GA 30097<br />
404-299-1700<br />
770-740-1860<br />
Atlanta, GA 30312 770-740-1860<br />
404-265-6997<br />
Page 54<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Otolaryngology Richman, Craig MD* Say, Phillip* Physical<br />
cont. 993 Johnson Ferry Rd Ne 4385 Johns Creek Pkwy Medicine and<br />
Ste 115 Ste 250<br />
Fulton County cont. Atlanta, GA 30342 Suwanee, GA 30024<br />
Rehabilitation<br />
Guffin, Thomas MD*<br />
404-256-7532 770-623-1608 DeKalb County<br />
2365 Old Milton Pkwy Tritt, Ramie MD* Say, Phillip*<br />
Ste 300<br />
Diaz, Ruben BS*<br />
5555 Peachtree 766 Walther Rd<br />
Alpharetta, GA 30009<br />
980 Johnson Ferry Rd Ne<br />
Dunwoody Rd Ste 300<br />
770-740-1860<br />
Ste 250<br />
Ste 135 Lawrenceville, GA 30045 Atlanta, GA 30340<br />
Guffin, Thomas MD*<br />
Atlanta, GA 30342 770-237-3000 770-962-6300<br />
6916 Mcginnis Ferry Rd<br />
404-255-2918<br />
Stewart, Fermin MD*<br />
Ste 100<br />
Feeman, Mark*<br />
Gwinnett County 4045 Johns Creek Pkwy<br />
Duluth, GA 30097<br />
2675 N Decatur Rd<br />
Ste C<br />
770-740-1860 Karlin, Scott MD*<br />
Ste 315<br />
Suwanee, GA 30024<br />
4385 Johns Creek Pkwy<br />
Decatur, GA 30033<br />
Hoffman, Joel MD*<br />
770-495-7116<br />
Ste 250<br />
404-659-5909<br />
2500 Hospital Blvd Suwanee, GA 30024 Tanghal, Liza*<br />
Ste 450<br />
Sholas, Maurice*<br />
770-623-1608 1700 Tree Lane Rd<br />
Roswell, GA 30076<br />
1405 Clifton Rd NE<br />
Ste 320<br />
770-343-8675 Karlin, Scott MD*<br />
Atlanta, GA 30322<br />
Snellville, GA 30078<br />
766 Walther Rd<br />
404-785-6000<br />
Hoffman, Joel MD*<br />
770-985-6864<br />
Ste 300<br />
2500 Hospital Blvd<br />
Solomon, Eric*<br />
Lawrenceville, GA 30045 Zweig, Julie*<br />
Ste 450<br />
2675 N Decatur Rd<br />
770-237-3000 4385 Johns Creek Pkwy<br />
Roswell, GA 30076<br />
Ste 315<br />
Ste 250<br />
770-343-8675 Raja, Mukund MD*<br />
Decatur, GA 30033<br />
Suwanee, GA 30024<br />
3500 Duluth Park Ln Bldg<br />
404-659-5909<br />
Larrivey, Roberto MD*<br />
770-623-1608<br />
600<br />
5555 Peachtree<br />
Taubin, Rhonda*<br />
Duluth, GA 30096 Zweig, Julie*<br />
Dunwoody Rd<br />
1942 Clairmont Rd<br />
770-622-0070 766 Walther Rd<br />
Ste 135<br />
Decatur, GA 30033<br />
Ste 300<br />
Atlanta, GA 30342 Raja, Mukund MD*<br />
404-367-1381<br />
Lawrenceville, GA 30045<br />
404-255-2918 4554 Jimmy Carter Blvd 770-237-3000 Fulton County<br />
Ste B<br />
Perry-Gilkes, Lisa MD* Norcross, GA 30093 Pain<br />
Apple, David*<br />
1136 Cleveland Ave 770-414-4661 Management 2020 Peachtree Rd NE<br />
Ste 621<br />
Atlanta, GA 30309<br />
East Point, GA 30344 Raja, Mukund MD*<br />
Gwinnett County 404-352-2020<br />
404-766-8110 475 Phillip Blvd<br />
Lawrenceville, GA 30045 Spaulding, Susan* Bilsky, Gerald*<br />
Perry-Gilkes, Lisa MD* 770-414-4661 2131 Fountain Dr 2020 Peachtree Rd NE<br />
3885 Princeton Lakes<br />
Snellville, GA 30078 Atlanta, GA 30309<br />
Way Roth, Jeffrey*<br />
770-979-0200<br />
404-352-2020<br />
Ste 312<br />
4385 Johns Creek Pkwy<br />
Atlanta, GA 30331-7100 Ste 250 Bowman, Brock*<br />
404-766-8110 Suwanee, GA 30024 2020 Peachtree Rd NE<br />
770-623-1608 Atlanta, GA 30309<br />
Richman, Craig MD*<br />
404-352-2020<br />
11685 Alpharetta Hwy Roth, Jeffrey*<br />
Ste 300 766 Walther Rd Figa, Daryl*<br />
Roswell, GA 30076 Ste 300 755 Mount Vernon Hwy<br />
770-475-3361 Lawrenceville, GA 30045 Ne Ste 370<br />
770-237-3000 Atlanta, GA 30328<br />
770-963-6300<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 55<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Physical<br />
Miller, Andrea* Vova, Joshua* Figa, Daryl*<br />
Medicine and 993F Johnson Ferry Rd 35 Jesse Hill Jr Dr 545 Old Norcross Rd<br />
Rehabilitation<br />
Ne Atlanta, GA 30303 Ste 300<br />
cont.<br />
Ste 260 404-785-9500 Lawrenceville, GA 30045<br />
Atlanta, GA 30342 770-963-6300<br />
Fulton County cont. 404-785-3300<br />
Vova, Joshua*<br />
5455 Meridian Mark Rd Figa, Daryl*<br />
Howard, Ernest* Rao, Heng* Ste 200 575 Professional Dr Ste<br />
1140 Hammond Dr Ne 35 Collier Rd Nw Ste 635 Atlanta, GA 30342 250<br />
Ste A<br />
Atlanta, GA 30309 404-785-2239 Lawrenceville, GA 30045<br />
Atlanta, GA 30328 404-367-3014 770-962-3883<br />
404-659-5909<br />
Vova, Joshua*<br />
Sholas, Maurice* 993F Johnson Ferry Rd Ghaffari, Saman DO*<br />
Howard, Ernest* 1001 Johnson Ferry Rd Ne 2121 Fountain Drive<br />
315 Boulevard Ne NE Ste 260 Ste D<br />
Ste 432<br />
Atlanta, GA 30342 Atlanta, GA 30342 Snellville, GA 30078<br />
Atlanta, GA 30312 404-785-5252 404-785-3300 770-674-4888<br />
404-659-5909<br />
Sholas, Maurice* Woodall, Lesli* Ghaffari, Saman DO*<br />
Kaelin, Darryl*<br />
11835 Alpharetta Hwy 1001 Johnson Ferry Rd 2160 Fountain Drive<br />
2020 Peachtree Rd NE Roswell, GA 30076 NE Ste C<br />
Atlanta, GA 30309 404-785-8470 Atlanta, GA 30342 Snellville, GA 30078<br />
404-352-2020<br />
Sholas, Maurice*<br />
404-785-5252 770-674-4888<br />
Leslie, Donald* 35 Jesse Hill Jr Dr Woodall, Lesli* Sholas, Maurice*<br />
2020 Peachtree Rd NE Atlanta, GA 30303 1405 Clifton Road Ne 4850 Sugarloaf Pkwy<br />
Atlanta, GA 30309 404-785-9500 Atlanta, GA 30342 Ste 501<br />
404-352-2020<br />
404-785-5252 Lawrenceville, GA 30044<br />
Sholas, Maurice* 404-785-8590<br />
Lin, John*<br />
5455 Meridian Mark Rd Woodall, Lesli*<br />
2020 Peachtree Rd NE Ste 200 35 Jesse Hill Jr Dr Vova, Joshua*<br />
Atlanta, GA 30309 Atlanta, GA 30342 Atlanta, GA 30303 4850 Sugarloaf Pkwy<br />
404-352-2020<br />
404-785-2239 404-785-9500 Lawrenceville, GA 30044<br />
404-785-8590<br />
Miller, Andrea* Sholas, Maurice* Woodall, Lesli*<br />
1001 Johnson Ferry Rd 993F Johnson Ferry Rd 5455 Meridian Mark Rd Thomas County<br />
NE<br />
Ne Ste 200<br />
Atlanta, GA 30342 Ste 260 Atlanta, GA 30342 Miller, David*<br />
404-785-5252<br />
Atlanta, GA 30342 404-785-2239<br />
421 E Jackson St<br />
404-785-3300<br />
Thomasville, GA 31792<br />
Miller, Andrea* Woodall, Lesli* 229-226-8850<br />
1405 Clifton Road NE Vova, Joshua*<br />
993F Johnson Ferry Rd<br />
Atlanta, GA 30332 1001 Johnson Ferry Rd Ne<br />
Plastic And<br />
404-785-1200 NE Ste 260<br />
Reconstructive<br />
Atlanta, GA 30342 Atlanta, GA 30342<br />
Miller, Andrea* Surgery<br />
404-785-5252 404-785-3300<br />
35 Jesse Hill Jr Dr<br />
Vova, Joshua*<br />
Fulton County<br />
Atlanta, GA 30303<br />
Gwinnett County<br />
404-785-9500 11835 Alpharetta Hwy<br />
Mackay, Gregory*<br />
Roswell, GA 30076 Diaz, Ruben BS*<br />
5673 Peachtree<br />
Miller, Andrea* 404-785-8470 545 Old Norcross Rd<br />
Dunwoody Rd Ne<br />
5455 Meridian Mark Rd Ste 300<br />
Ste 870<br />
Ste 200 Vova, Joshua*<br />
Lawrenceville, GA 30045<br />
1405 Clifton Road NE<br />
Atlanta, GA 30342<br />
Atlanta, GA 30342 770-963-6300<br />
Atlanta, GA 30332<br />
404-255-2975<br />
404-785-2239<br />
404-785-1200<br />
Page 56<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Plastic And Ghazi, Bahair* Clayton County Cain, Thomas*<br />
Reconstructive 1001 Johnson Ferry Rd 1459 Montreal Rd<br />
NE Bell, David*<br />
Surgery<br />
Ste 401<br />
cont.<br />
Atlanta, GA 30342 34 Upper Riverdale Road Tucker, GA 30084<br />
404-785-5252 Suite 203<br />
Fulton County cont.<br />
770-491-3680<br />
Riverdale, GA 30274<br />
Maske, Allyson MD* Haggerty, Staci PA-C* 770-907-7973 Gregory, Jimmy DPM*<br />
975 Johnson Ferry Rd 975 Johnson Ferry Rd 3546 Covington Hwy<br />
Ste 100<br />
Ste 100<br />
Thomas, Anastasia* Ste C<br />
Atlanta, GA 30342 Atlanta, GA 30342 34 Upper Riverdale Road Decatur, GA 30032-1483<br />
404-256-1311<br />
404-256-1311 Suite 203<br />
404-284-7744<br />
Riverdale, GA 30274<br />
Most, Daniel MD* McCluskey, Paul MD* 770-907-7973 Johnson, Vanita DPM*<br />
4370 Georgetown Sq 960 Johnson Ferry Rd NE 2227 Idlewood Rd<br />
Atlanta, GA 30338 Ste 245 Cobb County Tucker, GA 30084<br />
770-457-4677 Atlanta, GA 30342 678-205-2039<br />
404-499-0111<br />
Bouchard, James*<br />
Movagharnia, Faramarz<br />
4045A Lindley Cir Pierre, Felicia*<br />
MD*<br />
Williams, Joseph* Powder Springs, GA 5370 Highway 78<br />
200 Galleria Pkwy 5455 Meridian Mark Rd 30127<br />
Ste 120<br />
Ste 590<br />
Ste 200<br />
770-943-2121<br />
Stone Mountain, GA<br />
Atlanta, GA 30339 Atlanta, GA 30342 30087<br />
404-785-2239<br />
Thomas, Anastasia*<br />
770-951-7595 678-867-7053<br />
4045A Lindley Cir<br />
Work, Frederick MD* Williams, Joseph* Powder Springs, GA Raphael, Allen*<br />
1 Baltimore Pl NW 5455 Meridian Marks Rd 30127<br />
1116 E Ponce De Leon<br />
Ste 400<br />
NE<br />
770-943-2121<br />
Ave<br />
Atlanta, GA 30308 Ste 130<br />
Ste A<br />
Atlanta, GA 30342 DeKalb County<br />
404-885-9675<br />
Decatur, GA 30030<br />
404-255-2033<br />
Alder, David*<br />
404-299-7111<br />
Work, Frederick MD*<br />
Williams, Joseph* 1459 Montreal Rd<br />
One Baltimore Pl<br />
Raphael, Allen*<br />
975 Johnson Ferry Rd Ste 401<br />
Ste 400<br />
1525 E Park Place Blvd<br />
Ste 100 Tucker, GA 30084<br />
Atlanta, GA 30308<br />
Ste 300<br />
Atlanta, GA 30342 770-491-3680<br />
404-885-9675<br />
Stone Mountain, GA<br />
404-256-1311<br />
Austin-Harris, Corliss*<br />
30087<br />
Plastic Surgery<br />
1760 Candler Rd<br />
770-469-6069<br />
Podiatry Decatur, GA 30032<br />
DeKalb County Raphael, Allen*<br />
Clarke County<br />
404-286-2215 5370 Highway 78<br />
DiFrancesco, Lisa MD*<br />
Austin-Harris, Corliss*<br />
Ste 120<br />
150 East Ponce De Leon Bell, David*<br />
770 Village Square Drive<br />
Stone Mountain, GA<br />
Ave<br />
650 Oglethorpe Ave Ste 5<br />
Stone Mountain, GA<br />
30087<br />
Ste 190 Athens, GA 30606<br />
30083<br />
678-867-7053<br />
Decatur, GA 30030 706-548-2740<br />
404-298-8998<br />
404-377-3474<br />
Schlefman, Barbara<br />
Bouchard, James*<br />
Bell, David*<br />
DPM*<br />
Fulton County 650 Oglethorpe Ave Ste 5<br />
2784 N Decatur Rd<br />
2789 Joel Place<br />
Athens, GA 30606<br />
Decatur, GA 30033<br />
Atlanta, GA 30360<br />
Deutsch, Mark* 706-548-2740<br />
404-298-6050<br />
770-604-3803<br />
980 Johnson Ferry Rd Ne<br />
Ste 760<br />
Thomas, Anastasia*<br />
Bouchard, James*<br />
Shaheed, Naim*<br />
Atlanta, GA 30342 650 Oglethorpe Ave Ste 5<br />
2784 N Decatur Rd Ste<br />
5910 Hillandale Dr Ste<br />
770-461-2601 Athens, GA 30606<br />
150<br />
102<br />
706-548-2740<br />
Decatur, GA 30033<br />
Lithonia, GA 30058<br />
404-298-6050<br />
770-981-9011<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 57<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Podiatry cont. Gregory, Jimmy DPM* Raphael, Allen* Cain, Thomas*<br />
2391 Benjamin E Mays 5673 Peachtree 1800 Tree Ln<br />
DeKalb County Dr Sw Dunwoody Road Ste 320<br />
cont. Atlanta, GA 30311 Ste 470 Snellville, GA 30078<br />
Thomas, Anastasia*<br />
404-755-2291 Atlanta, GA 30342 770-979-1890<br />
2784 N Decatur Rd Ste<br />
404-237-3668<br />
Helfman, David DO* Castellano, Bradley*<br />
150 1350 Upper Hembree Schancupp, Joel MD* 3655 Howell Ferry Road<br />
Decatur, GA 30033 Road 1190 Grimes Bridge Rd Ste 100<br />
404-298-6050 Ste 100 Ste C Duluth, GA 30096<br />
Todd, Tobi MD*<br />
Roswell, GA 30076 Roswell, GA 30075 770-497-8283<br />
4480 Covington Highway<br />
770-663-8011 770-993-0880<br />
Kovalczyk, William MD*<br />
Ste A Johnson, Vanita DPM* Thomas, Anastasia* 3400 Centerville Hwy<br />
Decatur, GA 30035 3200 Downwood Cir NW 865 Holcomb Bridge Rd Snellville, GA 30039<br />
404-288-4117 Ste 340 Roswell, GA 30076 770-985-6789<br />
Ulett, Dane DO*<br />
Atlanta, GA 30327 770-992-9980<br />
404-367-5876<br />
Kron, Eric DPM*<br />
428 Winn Ct Todd, Tobi MD* 4700 Nelson Brogdon<br />
Decatur, GA 30030 Johnson, Vanita DPM* 2950 Stone Hogan Blvd<br />
404-299-7111 725 North Central Avenue Connector Rd Sw Buford, GA 30518<br />
Hapeville, GA 30354- Atlanta, GA 30331 678-889-9596<br />
Douglas County<br />
1935 404-349-5100<br />
404-761-2766<br />
Raphael, Allen*<br />
Bell, David*<br />
Ulett, Dane DO* 2850 Hog Mountain Rd<br />
4045 Lindley Circle<br />
Price, Jennifer MD* 35 Collier Rd NW Ste 101<br />
Douglasville, GA 30134<br />
5673 Peachtree STE 650 Dacula, GA 30019<br />
770-943-2121<br />
Dunwoody Road Atlanta, GA 30309 404-446-1940<br />
Fulton County<br />
Ste 470 404-446-1890<br />
Atlanta, GA 30342<br />
Raphael, Allen*<br />
Bell, David*<br />
404-237-3668<br />
Gwinnett County 3655 Howell Ferry Rd<br />
865 Holcomb Bridge Rd<br />
Ste 100<br />
Raphael, Allen* Alder, David*<br />
Roswell, GA 30076<br />
Duluth, GA 30096<br />
105 Collier Rd NW 1800 Tree Ln<br />
770-992-9980<br />
770-497-8283<br />
Ste 3060<br />
Ste 320<br />
Bouchard, James* Atlanta, GA 30309 Snellville, GA 30078 Raphael, Allen*<br />
865 Holcomb Bridge Rd 404-446-1890<br />
770-979-1890<br />
500 Medical Center Blvd<br />
Roswell, GA 30076<br />
Sutie 170<br />
Raphael, Allen* Bell, David*<br />
770-992-9980<br />
Lawrenceville, GA 30045<br />
1250 Upper Hembree Rd 15 Hurricane Shoalls Rd 770-237-3000<br />
Byrd, Eileen DPM* Suite A<br />
Lawrenceville, GA 30045<br />
1136 Cleveland Ave Roswell, GA 30076 770-277-7373<br />
Stepnicka, Jill DPM*<br />
Ste 305<br />
770-663-8011<br />
4355 Johns Creek<br />
Bouchard, James*<br />
East Point, GA 30344<br />
Parkway<br />
Raphael, Allen* 15 Hurricane Shoals Rd<br />
404-265-6154<br />
Ste 520<br />
550 Peachtree St Ne Lawrenceville, GA 30045 Suwanee, GA 30024<br />
Camasta, Craig DO* Ste 1430 770-277-7373<br />
770-418-0456<br />
5673 Peachtree Atlanta, GA 30309<br />
Branch, James DPM*<br />
Dunwoody Road 404-589-1330<br />
Thomas, Anastasia*<br />
4705 Lawrenceville<br />
Ste 470<br />
15 Hurricane Shoals Rd<br />
Raphael, Allen* Highway<br />
Atlanta, GA 30342<br />
Lawrenceville, GA 30045<br />
5673 Peachtree Lilburn, GA 30047<br />
404-237-3668<br />
770-277-7373<br />
Dunwoody Rd NE 770-921-8800<br />
Green, Rona DPM* Suite 470<br />
67 W. Campbellton Street Atlanta, GA 30342<br />
Fairburn, GA 30213-0188 404-237-3668<br />
770-946-2201<br />
Page 58<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Podiatry cont. DeKalb County Jackson, Harold* Tenhoor, Terri*<br />
5900 Hillandale Dr 2665 N Decatur Rd<br />
Gwinnett County Aristizabal, Jose* Ste F Ste 430<br />
cont. 2665 N Decatur Rd Lithonia, GA 30058 Decatur, GA 30033<br />
Ste 430<br />
Tirado, Lissette DPM*<br />
678-518-8000 404-294-0054<br />
Decatur, GA 30033<br />
445 Beaver Ruin Rd Nw 404-294-0054 Nathanson, Avery* Tenhoor, Terri*<br />
Ste A 2665 N Decatur Rd 5900 Hillandale Dr<br />
Lilburn, GA 30047 Demarini, Thomas* Ste 230 Ste F<br />
770-935-4443 2665 N Decatur Rd Decatur, GA 30033 Lithonia, GA 30058<br />
Ste 430<br />
Todd, Tobi MD*<br />
404-499-0533 678-518-8000<br />
Decatur, GA 30033<br />
3655 Howell Ferry Rd 404-294-0054 Nathanson, Avery* Wu, Chuansheng*<br />
Ste 100 5700 Hillandale Dr 2665 N Decatur Rd<br />
Duluth, GA 30096 Demarini, Thomas* Ste 190 Ste 430<br />
770-497-8283 320 Winn Way Lithonia, GA 30058 Decatur, GA 30033<br />
Ste 103<br />
Ulett, Dane DO*<br />
770-939-7707 404-294-0054<br />
Decatur, GA 30033<br />
3655 Howell Ferry Rd 404-508-6257 Pollock, Mark* Fulton County<br />
Duluth, GA 30096<br />
2665 N Decatur Rd<br />
770-497-8283 Demarini, Thomas* Ste 230<br />
Al Mulki, Mohammad*<br />
5900 Hillandale Dr Decatur, GA 30033 1136 Cleveland Ave<br />
Pulmonology Ste F 404-499-0533<br />
Ste 519<br />
Lithonia, GA 30058 Atlanta, GA 30344<br />
Clayton County 678-518-8000 Pollock, Mark* 404-761-3525<br />
5700 Hillandale Dr<br />
Demarini, Thomas* Hasan, Rana* Ste 190<br />
Alpert, Harold MD*<br />
181 Upper Riverdale Rd 2665 N Decatur Rd Lithonia, GA 30058 5555 Peachtree<br />
Sw Ste 430 770-939-7707<br />
Dunwoody Rd<br />
Bldg A Decatur, GA 30033 Ste 135<br />
Riverdale, GA 30274 404-294-0054 Saligheh, Ali* Atlanta, GA 30342<br />
770-994-3008 2665 N Decatur Rd 404-255-2918<br />
Hasan, Rana* Ste 230<br />
Hasan, Rana* 320 Winn Way Decatur, GA 30033 Demarini, Thomas*<br />
181 Upper Riverdale Rd Ste 103 404-499-0533<br />
4555 N Shallowford Rd<br />
Sw Decatur, GA 30033 Ste 206<br />
Bldg A 404-508-6257 Snyder, David* Atlanta, GA 30338<br />
Riverdale, GA 30274 2665 N Decatur Rd 770-451-8880<br />
770-994-3008 Hasan, Rana*<br />
Ste 430<br />
5900 Hillandale Dr Decatur, GA 30033 Henriques-Forsythe,<br />
Jackson, Harold* Ste F 404-294-0054<br />
Marshaleen MD*<br />
181 Upper Riverdale Rd Lithonia, GA 30058 75 Piedmont Avenue<br />
Sw 678-518-8000 Snyder, David* Ste 600<br />
Bldg A 320 Winn Way Atlanta, GA 30303<br />
Riverdale, GA 30274 Jackson, Harold* Ste 103 404-756-1410<br />
770-994-3008 1459 Montreal Rd Decatur, GA 30033<br />
Ste 307<br />
404-508-6257<br />
Henriques-Forsythe,<br />
Snyder, David* Tucker, GA 30084 Marshaleen MD*<br />
181 Upper Riverdale Rd 770-270-5557 Snyder, David* 80 Jesse Hill Jr Dr<br />
Sw 5900 Hillandale Dr Atlanta, GA 30303<br />
Bldg A Jackson, Harold* Ste F 404-616-5800<br />
Riverdale, GA 30274 320 Winn Way<br />
Lithonia, GA 30058<br />
770-994-3008 Ste 103<br />
678-518-8000<br />
Decatur, GA 30033<br />
404-508-6257<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 59<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Pulmonology cont. Kirchner, Kevin* Rockdale County Radiation<br />
5455 Meridian Mark Rd<br />
Demarini, Thomas* Oncology<br />
Fulton County cont. Ste 200<br />
Atlanta, GA 30342 1380 Milstead Ave Ne<br />
Johnson, Elizabeth PA-<br />
Cherokee County<br />
404-785-2239<br />
Ste C<br />
C* Conyers, GA 30012 Benton, James*<br />
1100 Lake Hearn Dr NE Mobbs, Mary* 770-922-2217 1200 Oakside Dr<br />
Ste 450 5455 Meridian Mark Rd Canton, GA 30114<br />
Atlanta, GA 30342 Ste 200 Demarini, Thomas*<br />
770-479-1761<br />
404-252-7339 Atlanta, GA 30342 1490 Milstead Rd Ne<br />
404-785-2239<br />
Ste A<br />
Critz, Frank*<br />
Johnson, Elizabeth PA- Conyers, GA 30012 1200 Oakside Dr<br />
C* Paterson, Tracy PA-C* 770-922-2217 Canton, GA 30114<br />
3300 Old Milton Parkway 1100 Lake Hearn Dr NE 770-479-1761<br />
STE 300 Ste 450<br />
Hasan, Rana*<br />
Alpharetta, GA 30005 Atlanta, GA 30342 1380 Milstead Ave Ne DeKalb County<br />
404-252-7339 404-252-7339<br />
Ste C<br />
Conyers, GA 30012 Benton, James*<br />
Johnson, Elizabeth PA- Snyder, David* 770-922-2217 2349 Lawrenceville Hwy<br />
C* 4555 North Shallowford Decatur, GA 30033<br />
5455 Meridian Marks Rd RD Hasan, Rana*<br />
404-320-1550<br />
NE STE 206<br />
1490 Milstead Rd Ne<br />
Ste 540 Atlanta, GA 30338 Ste A<br />
Gargus, John MD*<br />
Atlanta, GA 30342 770-451-8880<br />
Conyers, GA 30012 2349 Lawrenceville Hwy<br />
404-255-6509<br />
770-922-2217 Decatur, GA 30033<br />
Westney, Gloria* 404-320-1550<br />
Julius, Steven* 75 Piedmont Avenue Jackson, Harold*<br />
1001 Johnson Ferry Rd Ste 700<br />
1380 Milstead Ave Ne Holladay, David MD*<br />
NE Atlanta, GA 30303 Ste C<br />
2675 N Decatur Rd Ste<br />
Atlanta, GA 30342 404-756-1410<br />
Conyers, GA 30012 401<br />
404-785-5252<br />
770-922-2217 Decatur, GA 30033<br />
Gwinnett County<br />
404-501-7700<br />
Julius, Steven*<br />
Jackson, Harold*<br />
1100 Lake Hearn Dr NE Hasan, Rana*<br />
1490 Milstead Rd Ne Holladay, David MD*<br />
Ste 450<br />
4040 Johns Creek Pkwy Ste A<br />
2675 North Decatur Rd<br />
Atlanta, GA 30342 Ste 100<br />
Conyers, GA 30012 Suite 401<br />
404-252-7339<br />
Suwanee, GA 30024 770-922-2217 Decatur, GA 30033<br />
678-474-9277<br />
404-501-7700<br />
Julius, Steven*<br />
Snyder, David*<br />
5455 Meridian Mark Rd Jackson, Harold* 1380 Milstead Ave Ne Merlin, Mark*<br />
Ste 200<br />
4040 Johns Creek Pkwy Ste C<br />
2349 Lawrenceville Hwy<br />
Atlanta, GA 30342 Ste 100<br />
Conyers, GA 30012 Decatur, GA 30033<br />
404-785-2239<br />
Suwanee, GA 30024 770-922-2217 404-320-1550<br />
678-474-9277<br />
Kirchner, Kevin*<br />
Snyder, David* Randolph, Erich MD*<br />
1001 Johnson Ferry Rd Snyder, David* 1490 Milstead Rd Ne 1475 Montreal Road<br />
NE<br />
4040 Johns Creek Pkwy Ste A Tucker, GA 30084<br />
Atlanta, GA 30342 Ste 100<br />
Conyers, GA 30012 770-270-5085<br />
404-785-5252<br />
Suwanee, GA 30024 770-922-2217<br />
678-474-9277<br />
Williams, Tosha*<br />
Kirchner, Kevin*<br />
Tenhoor, Terri* 2349 Lawrenceville Hwy<br />
1100 Lake Hearn Dr NE Tenhoor, Terri* 1490 Milstead Rd Ne Decatur, GA 30033<br />
Ste 450<br />
4040 Johns Creek Pkwy Ste A 404-320-1550<br />
Atlanta, GA 30342 Ste 100<br />
Conyers, GA 30012<br />
404-252-7339<br />
Suwanee, GA 30024 770-922-2217<br />
678-474-9277<br />
Page 60<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Radiation<br />
McElveen, Tracy MD* Williams, Tosha* Holmes, Leslie*<br />
Oncology cont. 1000 Johnson Ferry Rd 1000 JOHNSON FERRY 311 Phillips St<br />
Ne ROAD Lawrenceville, GA 30045<br />
DeKalb County Atlanta, GA 30342 Atlanta, GA 30342 770-995-3000<br />
cont. 404-256-8000 404-851-8000<br />
Maxa, Leela MD*<br />
Williams III, Wilfred Medbery, Robena MD* Williams III, Wilfred 311 Philip Boulevard<br />
MD* 1136 Cleveland Ave MD* Lawrenceville, GA 30046<br />
2745 DeKalb Medical Ste 119 1000 Johnson Ferry Rd 770-995-3000<br />
Pkwy Atlanta, GA 30344 Atlanta, GA 30342<br />
Ste 100 404-466-6100 404-851-8850<br />
Maxa, Leela MD*<br />
Lithonia, GA 30058<br />
698 Duluth Highway<br />
770-255-7470<br />
Merlin, Mark* Williams III, Wilfred Lawrenceville, GA 30045<br />
1000 Johnson Ferry Rd MD* 770-962-8888<br />
Forsyth County Atlanta, GA 30342 3400 Old Milton Pkwy<br />
404-581-8850 Ste B<br />
Merlin, Mark*<br />
Benton, James*<br />
Alpharetta, GA 30005 2094 McGee Rd<br />
1055 Haw Creek Pkwy Nowlan, Adam MD* 770-255-7500<br />
Snellville, GA 30078<br />
Cumming, GA 30041 1968 Peachtree Rd NW 770-979-3705<br />
678-947-0457 Atlanta, GA 30309 Wobeck, Linda MD*<br />
404-605-3319 1968 Peachtree Rd NW Merlin, Mark*<br />
Critz, Frank*<br />
Atlanta, GA 30309 311 Phillips St<br />
1055 Haw Creek Pkwy Randolph, Erich MD* 404-605-3319<br />
Lawrenceville, GA 30045<br />
Cumming, GA 30041 1000 Johnson Ferry Rd 770-995-3000<br />
678-947-0457 NE Gwinnett County<br />
Atlanta, GA 30342<br />
Randolph, Erich MD*<br />
Merlin, Mark*<br />
404-851-8850<br />
Benton, James* 698 Duluth Hwy<br />
1055 Haw Creek Pkwy 2094 McGee Rd Lawrenceville, GA 30045<br />
Cumming, GA 30041 Randolph, Erich MD* Snellville, GA 30078 770-962-8888<br />
678-947-0457 320 Parkway NE 770-979-3705<br />
Atlanta, GA 30312<br />
Williams III, Wilfred<br />
Fulton County 404-265-3521<br />
Benton, James* MD*<br />
311 Phillips St<br />
698 Duluth Way<br />
Critz, Frank* Randolph, Erich MD* Lawrenceville, GA 30045 Ste 100<br />
1000 Johnson Ferry Rd 3400 Old Milton Pkwy 770-995-3000<br />
Lawrenceville, GA 30046<br />
Atlanta, GA 30342 Ste B 770-962-8888<br />
404-581-8850 Alpharetta, GA 30005 Critz, Frank*<br />
770-255-7500<br />
2094 McGee Rd Newton County<br />
Machuta-Fernandes, Snellville, GA 30078<br />
Shelley MD*<br />
Wilkinson, Craig MD* 770-979-3705<br />
Benton, James*<br />
1136 Cleveland Ave 1000 Johnson Ferry Rd<br />
7174 Wheat St Ne<br />
Ste 119 NE<br />
Critz, Frank* Covington, GA 30014<br />
Atlanta, GA 30344 Atlanta, GA 30342 311 Phillips St 770-787-4446<br />
770-466-6100 404-851-8850<br />
Lawrenceville, GA 30045<br />
770-995-3000<br />
Critz, Frank*<br />
Machuta-Fernandes, Wilkinson, Craig MD*<br />
7174 Wheat St Ne<br />
Shelley MD* 3330 Preston Ridge Road Gargus, John MD* Covington, GA 30014<br />
5665 Peachtree Suite 100<br />
2094 McGee Rd 770-787-4446<br />
Dunwoody Rd NE Alpharetta, GA 30005 Snellville, GA 30078<br />
Atlanta, GA 30342-7339 770-350-0126<br />
770-979-3705<br />
Merlin, Mark*<br />
404-851-5720<br />
7174 Wheat St Ne<br />
Wilkinson, Craig MD* Gargus, John MD* Covington, GA 30014<br />
McCord, Mark MD* 3400 Old Milton Pkwy 311 Phillips St 770-787-4446<br />
1000 Johnson Ferry Rd Ste B<br />
Lawrenceville, GA 30045<br />
NE Alpharetta, GA 30005 770-995-3000<br />
Atlanta, GA 30342 770-255-7500<br />
404-851-8850<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 61<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Specialists<br />
List of Plan <strong>Provider</strong>s<br />
Radiation Rheumatology Surgical Critical Murphy, Douglas MD*<br />
Oncology cont.<br />
Care<br />
5665 Peachtree<br />
DeKalb County<br />
Dunwoody Rd NE<br />
Rockdale County Fulton County STE 200<br />
Friedman, Michael MD* Atlanta, GA 30342<br />
Benton, James* 2675 N Decatur Rd Danner, Omar* 404-252-6104<br />
1293 Wellbrook Cir NE Ste 705 80 Jesse Hill Jr Dr SE<br />
Conyers, GA 30012 Decatur, GA 30033 Atlanta, GA 30303 Winston, Alan*<br />
770-922-2012 404-299-8600 404-616-1415<br />
5665 Peachtree<br />
Dunwoody Rd<br />
Critz, Frank* Fulton County Surgical<br />
Ste 200<br />
1293 Wellbrook Cir NE<br />
Oncology<br />
Atlanta, GA 30342<br />
Conyers, GA 30012 Chung, Eun Connie*<br />
404-252-6104<br />
770-922-2012 1265 Upper Hembree Rd<br />
Suite 205<br />
Fulton County<br />
Gargus, John MD* Thoracic Surgery<br />
Roswell, GA 30076<br />
1293 Wellbrook Circle<br />
Beech, Derrick*<br />
770-521-1587<br />
Conyers, GA 30012<br />
75 Piedmont Ave DeKalb County<br />
770-922-2012 Gwinnett County<br />
Ste 700<br />
Atlanta, GA 30303 Howard, Jeffrey*<br />
Holmes, Leslie*<br />
404-756-1400<br />
2701 N Decatur Road<br />
Kramer, Alan*<br />
1293 Wellbrook Cir NE<br />
Decatur, GA 30033<br />
3350 Paddocks Pkwy<br />
Conyers, GA 30012<br />
Beech, Derrick* 404-501-7925<br />
Suwanee, GA 30024<br />
770-922-2012 678-679-6210<br />
80 Jesse Hill Jr Dr<br />
Atlanta, GA 30303 Howard, Jeffrey*<br />
Merlin, Mark*<br />
404-616-5800<br />
2801 N Decatur Rd<br />
Parris, Glenn*<br />
1293 Wellbrook Cir NE<br />
Ste 395<br />
989 Lawrenceville Hwy<br />
Conyers, GA 30012 Thoracic<br />
Decatur, GA 30033<br />
Lawrenceville, GA 30045<br />
770-922-2012 Cardiovascular<br />
404-223-1349<br />
770-962-1616<br />
Surgery<br />
Stubbs, Michael*<br />
Radiology Sleep Medicine 465 Winn Way<br />
Fulton County Ste 211<br />
DeKalb County Fulton County<br />
Guy, Thomas MD*<br />
Decatur, GA 30030<br />
Berenson, Eric* Montgomery, Gary* 5665 Peachtree<br />
404-292-4348<br />
1190 W Druid Hills Rd NE 1001 Johnson Ferry Rd Dunwoody Rd<br />
Ste T-75<br />
Fulton County<br />
NE Ste 200<br />
Atlanta, GA 30329 Atlanta, GA 30342 Atlanta, GA 30342 Lee, Arthur*<br />
404-501-7120 404-785-5252 404-252-6104 80 Jesse Hill Jr Dr SE<br />
Berenson, Eric*<br />
Atlanta, GA 30303<br />
Montgomery, Gary* Langford, David MD*<br />
2701 N Decatur Rd<br />
404-616-4396<br />
1100 Lake Hearn Dr NE 5665 Peachtree<br />
Decatur, GA 30033 Ste 450 Dunwoody Rd NE Snyder, Averel MD*<br />
404-501-1000 Atlanta, GA 30342 STE 200 5665 Peachtree<br />
404-252-7339 Atlanta, GA 30342<br />
Berenson, Eric*<br />
Dunwoody Rd NE<br />
404-252-6104<br />
450 North Candler Street<br />
STE 200<br />
Spine Surgery<br />
Decatur, GA 30030<br />
Atlanta, GA 30342<br />
Macheers, Steven MD*<br />
404-377-0221<br />
404-252-6104<br />
Gwinnett County 5665 Peachtree<br />
Dunwoody Rd NE Souza, Renato*<br />
Renner, Courtney PA-C* STE 200 204 Senoia Rd<br />
1000 Medical Center Blvd Atlanta, GA 30342 Fairburn, GA 30213<br />
Lawrenceville, GA 30045 404-252-6104 770-964-9759<br />
770-622-0282<br />
Page 62<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Specialists<br />
Urgent Care DeKalb County Rheudasil, James MD*<br />
Medicine 5669 Peachtree<br />
Adeduntan, Azeez MD* Dunwoody Road<br />
DeKalb County<br />
2167 Northlake Parkway Ste 100<br />
Bldg 2 Suite 106 Atlanta, GA 30342<br />
Tacoronti, Rudolph* Tucker, GA 30084 404-256-0404<br />
5019 Lavista Rd 770-492-8636<br />
Tucker, GA 30084<br />
Tagoe, Albert MD*<br />
678-720-0422<br />
Rose, Kelli*<br />
1136 Cleveland Avenue<br />
2675 N Decatur Rd Suite 615<br />
Gwinnett County Suite 701<br />
East Point, GA 30344<br />
Decatur, GA 30033 770-474-3882<br />
Henderson, Philip* 404-299-6488<br />
289 Grayson Hwy Tagoe, Albert MD*<br />
Lawrenceville, GA 30045 Rose, William*<br />
1170 Cleveland Ave<br />
678-376-1300 2675 N Decatur Rd Atlanta, GA 30344<br />
Suite 701 404-305-3500<br />
Urology<br />
Decatur, GA 30033<br />
404-299-6488 Vivek, Uthan*<br />
DeKalb County<br />
3400 Old Milton Parkway<br />
Wildstein, Albert* Suite 300-A<br />
Kasow, Glenn* 2675 N Decatur Rd Alpharetta, GA 30005<br />
2179 Northlake Pkwy Ste 210<br />
770-771-5260<br />
Ste 109<br />
Decatur, GA 30033<br />
Tucker, GA 30084 404-292-5938<br />
Gwinnett County<br />
770-491-9400<br />
Fulton County Anegundi, Sudhindra<br />
Fulton County<br />
MD*<br />
Battey, Patrick MD* 600 Professional Dr Ste<br />
Franco, Ned MD* 35 Collier Rd Nw Ste 185 250<br />
960 Johnson Ferry Rd Ne Atlanta, GA 30309 Lawrenceville, GA 30045<br />
Ste 420 404-351-9741<br />
770-962-9977<br />
Atlanta, GA 30342<br />
404-252-2420<br />
Clark, Michael MD* Anegundi, Sudhindra<br />
5669 Peachtree MD*<br />
Vascular<br />
Dunwoody Rd Ne 631 Professional Dr<br />
Interventional<br />
#100 Ste 300<br />
Atlanta, GA 30342<br />
Radiology Lawrenceville, GA 30046<br />
404-256-0404 770-962-9977<br />
Fulton County H’Doubler, Peter MD* Henry County<br />
5669 Peachtree<br />
Ward, Garrett MD*<br />
234 Elden Drive<br />
Dunwoody Rd NE Menchion, Kenneth MD*<br />
Atlanta, GA 30342<br />
Ste 100<br />
1108 Hospital Drive<br />
770-619-2767<br />
Atlanta, GA 30342 Stockbridge, GA 30281<br />
404-256-0404 770-506-4105<br />
Vascular Surgery Rheudasil, James MD* Menchion, Kenneth MD*<br />
5669 Peachtree<br />
Clayton County<br />
350 Country Club Dr<br />
Dunwoody Rd NE Ste A<br />
Wildstein, Albert* Ste 100 Stockbridge, GA 30281<br />
86 Upper Riverdale Rd Atlanta, GA 30342 770-474-0640<br />
Sw<br />
404-256-0404<br />
Ste 201<br />
Riverdale, GA 30274<br />
770-996-9945<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 63<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Hospitals<br />
List of Plan <strong>Provider</strong>s<br />
Hospital<br />
Fulton County<br />
Clayton County<br />
Anchor Hospital<br />
5454 Yorktowne Drive<br />
Southern Regional Medical Atlanta, GA 30349<br />
Center* 770-991-6044<br />
11 Upper Riverdale Road Sw<br />
Riverdale, GA 30274<br />
Atlanta Medical Center<br />
770-909-2185<br />
303 Parkway Dr<br />
Atlanta, GA 30374<br />
DeKalb County<br />
404-265-4000<br />
DeKalb Medical Center* Gwinnett County<br />
2701 N Decatur Rd<br />
Decatur, GA 30033<br />
Summit Ridge Hospital<br />
404-501-1000<br />
250 Scenic Hwy<br />
Lawrenceville, GA 30046<br />
DeKalb medical Center at 678-442-5800<br />
Hillandale*<br />
2801 DeKalb Medical Pkwy Inpatient Substance<br />
Lithonia, GA 30058<br />
404-501-8000<br />
Abuse<br />
DeKalb County<br />
Fulton County<br />
Peachford Hospital<br />
Northside Hospital*<br />
2151 Peachford Road<br />
1000 Johnson Ferry Rd Ne Atlanta, GA 30338<br />
Atlanta, GA 30342 770-455-3200<br />
404-256-8000<br />
Fulton County<br />
Gwinnett County<br />
Anchor Hospital<br />
Gwinnett Medical Center* 5454 Yorktowne Drive<br />
1000 Medical Center Blvd Atlanta, GA 30349<br />
Lawrenceville, GA 30046 770-991-6044<br />
678-312-4321<br />
Atlanta Medical Center<br />
Gwinnett Medical Center - 303 Parkway Dr<br />
Duluth* Atlanta, GA 30374<br />
3620 Howell Ferry Rd 404-265-4000<br />
Duluth, GA 30096<br />
678-312-6800 Gwinnett County<br />
Inpatient Psychiatric<br />
Facility Services<br />
DeKalb County<br />
Peachford Hospital<br />
2151 Peachford Road<br />
Atlanta, GA 30338<br />
770-455-3200<br />
Summit Ridge Hospital<br />
250 Scenic Hwy<br />
Lawrenceville, GA 30046<br />
678-442-5800<br />
Page 64<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Skilled Nursing Facilities<br />
Skilled Nursing Facility<br />
DeKalb County<br />
Golden Living -Briarwood<br />
3888 LaVista Road<br />
Tucker, GA 30084<br />
770-938-5740<br />
Golden Living Center Decatur<br />
2787 North Decatur Road<br />
Decatur, GA 30033<br />
404-292-0626<br />
Golden Living Center Glenwood<br />
4115 Glenwood Road<br />
Decatur, GA 30032<br />
404-284-6414<br />
Fulton County<br />
Golden Living Center Northside<br />
5470 Meridian Mark Road<br />
Atlanta, GA 30342<br />
404-256-5131<br />
Gwinnett County<br />
Golden Living Center Medical<br />
Arts<br />
213 Scenic Highway<br />
Lawrenceville, GA 30045<br />
770-863-5275<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 65<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Outpatient Mental Health <strong>Provider</strong>s<br />
List of Plan <strong>Provider</strong>s<br />
Inpatient<br />
Fulton County Metro Behavioral Care Moseri, John MD<br />
Substance Abuse 1810 Peachtree Industrial 1810 Moseri Rd<br />
Behavioral Health Blvd Decatur, GA 30032<br />
DeKalb County<br />
Treatment Solutions Duluth, GA 30097 404-289-8223<br />
LLC 770-513-7666<br />
Newport Integrataed 7000 Peachtree Fulton County<br />
Behavioral Health Inc. Dunwoody Rd<br />
Metro Behavioral Care<br />
1800 Moseri Rd Atlanta, GA 30328 227 Scenic Hwy Beal, Eddie MD<br />
Decatur, GA 30032 678-234-6089 Lawrenceville, GA 30045 1093 Cleveland Ave<br />
404-289-8223<br />
770-513-7666<br />
East Point, GA 30344<br />
Northside Psychological 404-768-2218<br />
Outpatient Services<br />
Outpatient<br />
5755 N Point Pkwy Burke, Michael MD<br />
Mental Health<br />
Substance Abuse<br />
Alpharetta, GA 30022<br />
80 Jessie Hill Jr Dr SE<br />
770-667-3877 Program Atlanta, GA 30303<br />
DeKalb County<br />
404-616-4307<br />
Optimal Psychological DeKalb County<br />
Atlanta Network For<br />
Services Inc<br />
Conley, Michael MD<br />
Indicidual & Family<br />
Peachford Hospital<br />
1830 Water Place<br />
285 Boulevard NE<br />
Therapy<br />
2151 Peachford Road<br />
Atlanta, GA 30339<br />
Atlanta, GA 30312<br />
1864 Independence Sq Atlanta, GA 30338<br />
678-528-5816<br />
404-681-4100<br />
Dunwoody, GA 30338 770-455-3200<br />
770-668-0350 Optimal Psychological<br />
Hindash, Osama MD<br />
Services Inc<br />
Fulton County 801 Macy Dr<br />
Ausborn Behavioral<br />
5755 N Point Pkwy Anchor Hospital<br />
Roswell, GA 30076<br />
Care PC<br />
Alpharetta, GA 30022 5454 Yorktowne Drive<br />
678-795-0346<br />
4500 Hugh Howell Rd<br />
Tucker, GA 30084<br />
678-528-5816 Atlanta, GA 30349 Winn, Stephanie MD<br />
770-938-4616 770-991-6044<br />
Gwinnett County<br />
80 Jessie Hill Jr Dr SE<br />
Atlanta Medical Center<br />
Atlanta, GA 30303<br />
Littlejohn Consulting &<br />
Christian Counseling<br />
303 Parkway Dr<br />
404-616-4307<br />
Psychological Services<br />
And Psychological<br />
LLC<br />
Atlanta, GA 30374<br />
Services<br />
Gwinnett County<br />
315 W Ponce De Leon<br />
404-265-4000<br />
2910 Horizon Park Dr<br />
Ave<br />
Suwannee, GA 30024<br />
Ajayi, Ganiat MD<br />
Decatur, GA 30030<br />
Gwinnett County<br />
770-271-8989<br />
4330 S Lee Street<br />
404-373-2220<br />
Social Empowerment<br />
Buford, GA 30518<br />
Dunwoody Psychology Center<br />
678-889-4944<br />
Newport Integrated<br />
Inc<br />
Behavioral Healthcare<br />
504 Indian Trail Rd<br />
3790 Holcomb Bridge<br />
Makim, Shripal MD<br />
Inc<br />
Lilburn, GA 30047<br />
Road<br />
227 Scenic Hwy<br />
1810 Moseri Rd 770-925-2095<br />
Norcross, GA 30092<br />
Lawrenceville, GA 30045<br />
Decatur, GA 30032<br />
770-312-2319 Summit Ridge Hospital<br />
770-513-7666<br />
404-289-8223<br />
250 Scenic Hwy<br />
Grace Point Counseling<br />
Reddy, Rohini MD<br />
Sullivan Psychiatric<br />
Lawrenceville, GA 30046<br />
Associates LLC<br />
227 Scenic Hwy<br />
Services 678-442-5800<br />
620 Hillcrest Road<br />
Lawrenceville, GA 30045<br />
425 Allgood Rd<br />
Lilburn, GA 30047<br />
770-513-7666<br />
Stone Mountain, GA<br />
Psychiatry<br />
770-638-1577<br />
30083<br />
Shah, Mahendra MD<br />
404-633-6626<br />
DeKalb County<br />
Heritage Medical<br />
227 Scenic Hwy<br />
Solutions<br />
Lee, Steven MD<br />
Lawrenceville, GA 30045<br />
4330 S Lee Street 2150 Peachford Rd<br />
770-513-7666<br />
Buford, GA 30518 Atlanta, GA 30338 Val, Franckel MD<br />
678-889-4944 770-452-0270 2795 Main St<br />
Snellville, GA 30078<br />
678-344-4465<br />
Page 66<br />
2012 Advantage by Peach State Health Plan HMO SNP<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
List of Plan <strong>Provider</strong>s<br />
Outpatient Mental Health <strong>Provider</strong>s<br />
Psychology<br />
DeKalb County<br />
Social Worker<br />
DeKalb County<br />
Childs, Gwendolyn PhD Foster-Penn, Nancy<br />
1012 Main St LCSW<br />
Stone Mountain, GA 5165 Lavista Rd<br />
30083 Tucker, GA 30084<br />
770-498-2865 770-908-1746<br />
Goldstein, Marvin PhD Furtner, Jane LCSW<br />
4651 Chamblee- 6755 Peachtree Industrial<br />
Dunwoody<br />
Blvd<br />
Atlanta, GA 30338 Atlanta, GA 30360<br />
770-512-8000 770-825-0448<br />
Hebblewhite, Mary PhD Fulton County<br />
2200 Century Pkwy<br />
Atlanta, GA 30345 Coolidge, Mary<br />
404-325-0304<br />
Katherine LCSW<br />
7560 Butner Road<br />
Littlejohn, Eugia PhD Fairburn, GA 30213<br />
315 W Ponce De Leon 770-306-7878<br />
Ave<br />
Decatur, GA 30030 Gwinnett County<br />
404-373-2220<br />
Wright, Faith LCSW<br />
McCampbell, Elizabeth 1310 Rockbirdge Rd<br />
PhD<br />
Stone Mountain, GA<br />
1050 Crown Pointe Pkwy 30087<br />
Atlanta, GA 30338 770-381-2230<br />
770-551-2775<br />
Fulton County<br />
Cooley, June PSYD<br />
5825 Glenridge Dr<br />
Atlanta, GA 30328<br />
770-417-2733<br />
Elston, Sigrid PhD<br />
2941 Piedmont Road<br />
Atlanta, GA 30305<br />
404-869-9474<br />
Hutchings, Forrest PhD<br />
22 Lenox Pointe<br />
Atlanta, GA 30324<br />
404-325-0100<br />
Rosenthal, Robin PhD<br />
340 Boulevard NE<br />
Atlanta, GA 30312<br />
404-653-0322<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 67<br />
*<strong>Provider</strong>s identified with an *asterisk also accept Medicaid.
Pharmacies<br />
We call the pharmacies on this list our “network pharmacies” because we have<br />
made arrangements with them to provide prescription drugs to Plan members.<br />
A network pharmacy is a pharmacy where beneficiaries obtain prescription<br />
drug benefits provided by Advantage by Peach State. In most cases, your<br />
prescriptions are covered under Advantage by Peach State only if they are filled<br />
at a network pharmacy or through our mail order pharmacy service. Once you<br />
go to one, you are not required to continue going to the same pharmacy to fill<br />
your prescription. You can go to any of our network pharmacies. We will fill<br />
prescriptions at non-network pharmacies under certain circumstances as<br />
described in your Evidence of Coverage. The inclusion of a pharmacy in this<br />
directory does not guarantee that the pharmacy is open or is at same<br />
location listed.
List of Plan <strong>Provider</strong>s<br />
Pharmacies<br />
DeKalb County DeKalb Health Pharmacy Kroger Pharmacy<br />
1524 Church St Ste D 2036 Johnson Ferry Road<br />
Target Pharmacy Decatur, GA 30030-6500 Atlanta, GA 30319<br />
100 Perimeter Ctr Pl 404-270-9242 770-452-1423<br />
Atlanta, GA 30346<br />
678-259-0889 CVS Pharmacy Target Pharmacy<br />
1610 Mt Vernon Rd Ste100 2055 W Park Place Blvd<br />
Kroger Pharmacy Atlanta, GA 30338 Stone Mountain, GA 30087<br />
101 Fairview Road 770-671-2797 770-498-5886<br />
Ellenwood, GA 30294<br />
770-389-7088 Atlanta Ent Sinus And Allergy Walgreens #6138<br />
Associates<br />
2065 S Hairston Rd<br />
Publix Pharmacy 17 Executive Park Drive Decatur, GA 30035<br />
104 Town Blvd Ste 250 770-322-0468<br />
Suite A100 Atlanta, GA 30329<br />
Atlanta, GA 30319<br />
678-904-4390<br />
Publix Pharmacy<br />
404-233-7480 2075 S Hairston Road<br />
Dunwoody Urgent Care Decatur, GA 30035<br />
CVS Pharmacy 1730 B Mount Vernon Road 770-322-6557<br />
1140 N Hairston Rd Dunwoody, GA 30338<br />
Stone Mountain, GA 30083 770-353-2001<br />
Walgreens #7741<br />
404-292-0484 2144 Johnson Ferry Rd NE<br />
Wal-Mart Pharmacy Atlanta, GA 30319-2558<br />
CVS Pharmacy 1825 Rockbridge Rd 770-234-9839<br />
1144 S Indian Creek Drive Stone Mountain, GA 30087<br />
Stone Mountain, GA 30083 770-469-8570<br />
Publix Pharmacy<br />
404-296-2936 2155 N Decatur Road<br />
The Pharmacy Center Decatur, GA 30030<br />
Apothecare Pharmacies Inc 1835 Savoy Dr 404-638-6166<br />
1192 Rockbridge Rd Ste 104<br />
Suite B<br />
Atlanta, GA 30341<br />
Publix Pharmacy<br />
Stone Mountain, GA 30087-2903 770-270-1115<br />
2162 Henderson Mill Road<br />
770-923-6311 Atlanta, GA 30345<br />
DeKalb Grady Health Center 770-621-0227<br />
Kroger Pharmacy<br />
Pharmacy<br />
1227 Rockbridge Road 1863 Memorial Dr SE<br />
Kroger Pharmacy<br />
Stone Mountain, GA 30087 Atlanta, GA 30317-2103<br />
2175 Parklake Dr NE<br />
770-225-1888 404-616-9351<br />
Atlanta, GA 30345<br />
770-496-5314<br />
Kroger Pharmacy<br />
Wal-Mart Pharmacy<br />
1232 S Hairst0N Rd 1871 Chamblee Tucker Rd Kroger Pharmacy<br />
Stone Mt, GA 30088<br />
Chamblee, GA 30341<br />
2205 Lavista Road<br />
404-292-5542 770-455-4699<br />
Atlanta, GA 30329<br />
404-633-4201<br />
The Pharmacy at Emory Sams Pharmacy<br />
1365A Clifton Rd NE Rm A2000 1940 Mountain Industrial Blvd McKinneys Apothecary Inc<br />
Atlanta, GA 30322-1013<br />
Tucker, GA 30084<br />
225 E Ponce De Leon Ave<br />
404-778-2022 678-280-0236<br />
Suite 140<br />
Decatur, GA 30030<br />
Family Practice of Atlanta LLC Allstate Pharmacy 404-378-5408<br />
1428 Scott Blvd 1940 Parker Ct Ste D<br />
Decatur, GA 30030-1424 Stone Mountain, GA 30087-3456 CVS Pharmacy<br />
404-296-8100 770-978-7400<br />
225 W Ponce Deleon Ave<br />
Decatur, GA 30030<br />
Una Pharmacy Corporation Walgreens #5580 404-373-9627<br />
1462 Montreal Rd Ste 101 2035 Candler Rd<br />
Tucker, GA 30084-6904 Decatur, GA 30032<br />
770-934-0000 404-284-8812<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 69
Pharmacies<br />
List of Plan <strong>Provider</strong>s<br />
DeKalb County cont. Briarcliff Pharmacy Walgreens #6205<br />
2724 Clairmont Rd NE 2945 Panola Road<br />
Walgreens #12262 Atlanta, GA 30329 Lithonia, GA 30038<br />
2320 N Druid Hills Rd NE 404-728-0092 770-322-9110<br />
Atlanta, GA 30329-3109<br />
404-248-1793 CVS Pharmacy Publix Pharmacy<br />
2738 N Decatur Rd 2969 N Druid Hills Road<br />
Palliative Pharmacy Solutions Inc Decatur, GA 30033 Atlanta, GA 30329<br />
2338 Main St 404-508-2456 404-638-6252<br />
Tucker, GA 30084<br />
770-934-2976 Walgreens #7478 Sams Pharmacy<br />
2781 Lavista Rd 2994 Turner Hill Road<br />
Kroger Pharmacy Decatur, GA 30033 Lithonia, GA 30058<br />
2385 Wesley Chapel Rd 404-929-0562 770-482-1720<br />
Decatur, GA 30035<br />
770-987-1400 Kid & Teens Primary Healthcare Total Health Medical Center<br />
PC<br />
3009 Rainbow Dr<br />
Target Pharmacy 2785 Lawrenceville Hwy Ste 207 Ste 139<br />
2400 N Druid Hill Rd NE Decatur, GA 30033-2515 Decatur, GA 30034<br />
Atlanta, GA 30329 770-621-0245 404-241-7062<br />
404-267-0061<br />
CVS Pharmacy<br />
Publix Pharmacy<br />
Royal Style Pharmacy 2830 N Druid Hills Rd NE 3045 Panola Road<br />
2415 DeKalb Medical Pkwy Ste B Atlanta, GA 30329 Lithonia, GA 30038<br />
Lithonia, GA 30058-4929 404-679-4666 770-322-5480<br />
770-837-9034<br />
Rite Aid Pharmacy 11691 Rite Aid Pharmacy 11694<br />
CVS Pharmacy 2846 Lavista Road 3140 Turner Hill Road<br />
2444 Wesley Chapel Rd Decatur, GA 30033 Lithonia, GA 30038<br />
Decatur, GA 30035 404-633-0479 678-323-8559<br />
770-981-2532<br />
Kroger Pharmacy Walgreens #9621<br />
CVS Pharmacy 2875 N Decatur Road 315 Fairview Rd<br />
2458 Candler Rd Decatur, GA 30033 Ellenwood, GA 30294<br />
Decatur, GA 30032 404-294-8211 770-474-2025<br />
404-284-9718<br />
Rite Aid Pharmacy 11792 Tracys Medicine Center<br />
CVS Pharmacy 2886 Memorial Drive Southeast 3171 Tucker Norcross Rd<br />
2500 Mt Vernon Rd Atlanta, GA 30317 Tucker, GA 30084<br />
Dunwoody, GA 30338 404-370-0585 770-939-1642<br />
770-394-5131<br />
Sams Pharmacy<br />
Atlanta Family Physicians<br />
CVS Pharmacy 2901 A Clairmont Road 3424 Flat Shoals Rd<br />
2586 Lawrenceville Hwy Atlanta, GA 30329 Decatur, GA 30034-6525<br />
Decatur, GA 30033 404-325-1341 404-968-8269<br />
770-491-8616<br />
CVS Pharmacy<br />
CVS Pharmacy<br />
Kroger Pharmacy 2910 Buford Hwy 3439 Ashford Dunwoody Rd<br />
2626 Rainbow Way Atlanta, GA 30329 Atlanta, GA 30319<br />
Decatur, GA 30034 404-325-2735 770-216-8605<br />
404-243-0114<br />
Wal-Mart Pharmacy<br />
Kroger Pharmacy<br />
Walgreens 2940 Anvil Block Rd 3479 Memorial Drive<br />
2675 N Decatur Rd Ellenwood, GA 30294 Decatur, GA 30032<br />
Decatur, GA 30033-6131 404-361-2981 404-286-5788<br />
404-299-5411<br />
Page 70<br />
2012 Advantage by Peach State Health Plan HMO SNP
List of Plan <strong>Provider</strong>s<br />
Pharmacies<br />
DeKalb County cont. Kroger Pharmacy Publix Pharmacy<br />
3855 Buford Highway 4422 Hugh Howell Rd<br />
Rite Aid Pharmacy 11802 Atlanta, GA 30329 Tucker, GA 30084<br />
3549 Chamblee Tucker Road 404-325-5292 770-621-3186<br />
Chamblee, GA 30341<br />
770-455-8620 Publix Pharmacy Kroger Pharmacy<br />
3870 N Druid Hills Road 4498 Chamblee Dunwoody Rd<br />
Kroger Pharmacy Decatur, GA 30033 Dunwoody, GA 30338<br />
3559 Chamblee Tucker Road 404-633-6466 770-451-7408<br />
Chamblee, GA 30345<br />
770-216-2245 Kroger Pharmacy Rite Aid Pharmacy 11799<br />
3871 Peachtree Road NE 4621 N Shallowford Road<br />
Wal-Mart Pharmacy Atlanta, GA 30319 Dunwoody, GA 30338<br />
3580 Memorial Drive 404-240-2814 770-455-4681<br />
Decatur, GA 30032<br />
404-284-0707 Kroger Pharmacy The Medicine Shoppe<br />
3959A Lavista Road<br />
4675 N Shallowford Rd<br />
Walgreens #6481 Tucker, GA 30084 Ste 101<br />
3584 Wesley Chapel Rd 770-934-6442 Dunwoody, GA 30338<br />
Decatur, GA 30034 770-455-1144<br />
770-987-0787 Rite Aid Pharmacy 11801<br />
3964 Peachtree Road Northeast Wal-Mart Pharmacy<br />
CVS Pharmacy Atlanta, GA 30319 4725 Ashford-Dunwoody<br />
3615 Clairmont Rd 404-237-2194 Atlanta (N), GA 30338<br />
Atlanta, GA 30319 770-395-7946<br />
404-320-6658 Rite Aid Pharmacy 11726<br />
4005 Lawrenceville Highway Walgreens #7995<br />
CVS Pharmacy Tucker, GA 30084 4765 Redan Rd<br />
3637 Peachtree Rd NE 770-934-3585 Stone Mountain, GA 30088<br />
Atlanta, GA 30319 404-299-5322<br />
404-926-3541 CVS Pharmacy<br />
4037 Glenwood Rd Rite Aid Pharmacy 11693<br />
Publix Pharmacy Decatur, GA 30032 4855 Flat Shoals Pkwy<br />
3649 Flakes Mill Rd 404-288-4881 Decatur, GA 30034<br />
Decatur, GA 30034 770-987-3824<br />
770-322-2386 Rite Aid Pharmacy 11690<br />
4110 Memorial Drive Caring Pharmacy<br />
Tracys Medicine Center Decatur, GA 30032 4897 Buford Hwy<br />
3650 Chamblee Tucker Rd 404-294-6504 Suite 100<br />
Chamblee, GA 30341-4412 Chamblee, GA 30341<br />
770-934-7703 Target Pharmacy 770-807-0395<br />
4241 La Vista Road<br />
Publix Pharmacy Tucker, GA 30084 Kroger Pharmacy<br />
380 N Deshon Rd 770-934-3563 4915 Flat Shoals Parkway<br />
Stone Mountain, GA 30087 Decatur, GA 30034<br />
770-879-2706 CVS Pharmacy 770-322-3138<br />
4317 Chamblee Tucker Rd<br />
North DeKalb Health Center Tucker, GA 30084 Colliers Personal Care Pharmacy<br />
Pharmacy 770-938-6147 5 Dunwoody Park<br />
3807 Clairmont Rd NE Ste 102<br />
Chamblee, GA 30341 Kroger Pharmacy Atlanta, GA 30338<br />
404-616-3031 4357 Lawrenceville Highway 678-441-0045<br />
Tucker, GA 30084<br />
CVS Pharmacy 770-934-8322 Robert E. Springer III, Md, PC<br />
3820 N Decatur Rd 50 Executive Park S NE Ste 5012<br />
Decatur, GA 30032 Wal-Mart Pharmacy Atlanta, GA 30329-2214<br />
404-299-9154 4375 Lawrenceville Hwy 404-920-6201<br />
Tucker, GA 30084<br />
770-939-9278<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 71
Pharmacies<br />
List of Plan <strong>Provider</strong>s<br />
DeKalb County cont. Carltons Dunwoody Pharmacy CVS Pharmacy<br />
5484 Chamblee-Dunwoody Rd 7550 Covington Hwy<br />
Wai Kiu Famcare Pharmacy Ste B-19 Lithonia, GA 30058<br />
5150 Buford Hwy Dunwoody, GA 30338-4114 770-482-4823<br />
Ste B180 770-394-3233<br />
Doraville, GA 30340<br />
CVS Pharmacy<br />
770-455-8882 Walgreens #7167 80 Fairview Rd<br />
5511 A Chamblee Dunwoody Ellenwood, GA 30294<br />
Publix Pharmacy Dunwoody, GA 30338 770-474-7926<br />
5158 Memorial Dr Ste 402 770-671-9037<br />
Stone Mountain, GA 30083<br />
Target Pharmacy<br />
770-297-5016 Rite Aid Pharmacy 11798 8109 Mall Pkwy<br />
5556 Chamblee Dunwoody Road Lithonia, GA 30038<br />
Walgreens #10457 Dunwoody, GA 30338 678-259-0047<br />
5201 Lavista Rd 770-394-8407<br />
Tucker, GA 30084<br />
Genesys Pediatrics<br />
770-724-1042 Kmart Pharmacy4451 8225 Mall Parkway<br />
5597 Buford Hwy Ste 250<br />
Kims Pharmacy Inc Doraville, GA 30340 Lithonia, GA 30038<br />
5280 Buford Hwy 770-455-7218 770-987-2323<br />
Ste A<br />
Doraville, GA 30340-1117 Colliers Pharmacy Discount Pharmacy LLC<br />
770-455-7700 5705 Buford Hwy 827 N Hairston Rd Ste D<br />
Doraville, GA 30340 Stone Mountain, GA 30083-3441<br />
Walgreens #5336 770-455-4433 770-755-5904<br />
5320 Memorial Dr<br />
Stone Mountain, GA 30083 CVS Pharmacy Kroger Pharmacy<br />
404-508-6499 5755 Rockbridge Rd 8331 Roswell Road<br />
Stone Mountain, GA 30087 Atlanta, GA 30338<br />
C & S Healthcare Inc 770-469-7992 770-998-3043<br />
5360 Snapfinger Woods Dr<br />
Ste 128 CVS Pharmacy Comfort Pharmacy 2<br />
Decatur, GA 30035 5764 Peachtree Industrial Blvd 870 Main St<br />
770-987-2642 Chamblee, GA 30341 Stone Mountain, GA 30083-3621<br />
770-457-4401 770-469-4688<br />
Walgreens #2359<br />
5373 Peachtree Industrial Blvd Walgreens #5759 Global Pharmacy<br />
Chamblee, GA 30341 585 DeKalb Industrial Way 926 Montreal Rd<br />
678-547-1028 Decatur, GA 30030 Ste 2<br />
404-292-4776 Clarkston, GA 30021<br />
Metta International Pharmacy 404-299-8255<br />
5389 New Peachtree Rd Kroger Pharmacy<br />
Ste E 6678 Covington Highway Kroger Pharmacy<br />
Atlanta, GA 30341 Lithonia, GA 30058 965 N Harriston Road<br />
770-451-0363 770-593-7111 Stone Mountain, GA 30088<br />
770-413-1931<br />
Wal-Mart Pharmacy Walgreens #6202<br />
5401 Fairington Road 6771 Covington Hwy Fulton County<br />
Lithonia, GA 30038 Lithonia, GA 30058<br />
770-593-4998 678-418-8101<br />
Northside Homecare Pharmacy<br />
1000 Johnson Ferry Rd NE<br />
Walgreens #7608 CVS Pharmacy Atlanta, GA 30342-1611<br />
5435 Five Forks Trickum Rd SW 7207 Rockbridge Rd 404-851-8897<br />
Stone Mountain, GA 30087 Stone Mountain, GA 30087<br />
770-935-5439 770-469-2002<br />
Publix Pharmacy<br />
1001 Ponce De Leon<br />
Atlanta, GA 30306<br />
404-898-0360<br />
Page 72<br />
2012 Advantage by Peach State Health Plan HMO SNP
List of Plan <strong>Provider</strong>s<br />
Pharmacies<br />
Fulton County cont. Wender and Roberts Assisted Paylow Pharmacy<br />
Living 1180 Fairburn Rd SW Ste 500<br />
Wal-Mart Pharmacy 10930 Crabapple Rd Atlanta, GA 30331<br />
1030 Delta Blvd Ste 7B 404-349-9940<br />
Atlanta, GA 30354-1989 Roswell, GA 30075<br />
404-773-3200 770-992-7300<br />
Publix Pharmacy<br />
11800 Haynes Bridge Rd<br />
CVS Pharmacy Kroger Pharmacy Alpharetta, GA 30004<br />
1043 Cleveland Ave 10945 State Bridge Rd 770-752-4966<br />
East Point, GA 30344 Alpharetta, GA 30022<br />
404-767-2034 770-751-3010<br />
Pyramid Discount Pharmacy<br />
1185 Cleveland Ave<br />
Pharmacy of Southside Medical Rite Aid Pharmacy 11796 East Point, GA 30344<br />
Center Inc 1100 Hammond Drive 404-559-0715<br />
1046 Ridge Ave Atlanta, GA 30328<br />
Atlanta, GA 30315-1611 770-522-8194<br />
Rite Aid Pharmacy 11680<br />
404-564-7024 11855 Jones Bridge Road<br />
Publix Pharmacy Alpharetta, GA 30005<br />
Delta Employee Care Pharmacy 1100 Hammond Drive Suite 300 770-521-1292<br />
1050 Delta Blvd Atlanta, GA 30328<br />
Atlanta, GA 30354-1989<br />
678-443-2106<br />
Kroger Pharmacy<br />
404-305-9062 11877 Douglas Road<br />
Surgimed Suppliers Alpharetta, GA 30005<br />
Sams Pharmacy 11180 Statebridge Rd 770-751-3651<br />
10600 Davis Drive Suite 202<br />
Alpharetta, GA 30004<br />
Alpharetta, GA 30022<br />
CVS Pharmacy<br />
770-992-1211 678-879-0721<br />
12 J Broad St SW<br />
Atlanta, GA 30303<br />
CVS Pharmacy Target Pharmacy 404-681-1976<br />
10710 State Bridge Rd 1135 Woodstock Road<br />
Alpharetta, GA 30022<br />
Roswell, GA 30075<br />
CVS Pharmacy<br />
770-346-8432 770-998-7122<br />
12070 Crabapple Rd<br />
Roswell, GA 30075<br />
Walgreens #6875 Concord Drugs 770-992-5446<br />
10790 Alpharetta Hwy 1150 Lake Hearn Dr<br />
Roswell, GA 30076 Ste 120<br />
Rite Aid Pharmacy 11677<br />
770-645-0382 Atlanta, GA 30342<br />
12155 Houze Road<br />
404-781-2229<br />
Alpharetta, GA 30004<br />
Rite Aid Pharmacy 11731 678-762-1429<br />
10820 Abbott’S Bridge Road Publix Pharmacy<br />
Duluth, GA 30097<br />
11585 Jones Bridge Rd<br />
Kroger Pharmacy<br />
770-814-8919 Alpharetta, GA 30022<br />
1225 Caroline St<br />
770-751-4586<br />
Atlanta, GA 30307<br />
Wender & Roberts - Crabapple 404-880-4109<br />
10930 Crabapple Rd Kroger Pharmacy<br />
Roswell, GA 30075 1160 Moreland Ave<br />
Walgreens #11993<br />
770-992-4111 Atlanta, GA 30316<br />
12305 Crabapple Rd<br />
404-624-8115<br />
Alpharetta, GA 30004<br />
Wender & Roberts - LTC 678-393-9858<br />
10930 Crabapple Rd CVS Pharmacy<br />
Ste 7B<br />
11625 Jones Bridge Rd<br />
Kroger Pharmacy<br />
Roswell, GA 30075<br />
Alpharetta, GA 30005-2539 12460 Crabapple Road<br />
770-992-7300 770-752-4642<br />
Alpharetta, GA 30004<br />
CVS Pharmacy<br />
11710 Alpharetta Hwy<br />
Roswell, GA 30076<br />
770-754-0141<br />
770-740-2060<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 73
Pharmacies<br />
List of Plan <strong>Provider</strong>s<br />
Fulton County cont. Rite Aid Pharmacy 11676 Tuxedo Pharmacy<br />
142 S Main St 164 W Wieuca Rd<br />
Asa Yancey Health Center Alpharetta, GA 30004 Ste 7<br />
Pharmacy 770-752-9011 Atlanta, GA 30342-3316<br />
1247 Donald Lee Hollowell Pkwy 404-255-3022<br />
NW<br />
Publix Pharmacy<br />
Atlanta, GA 30318 1425 Market Blvd Suite 600 Kroger Pharmacy<br />
404-616-9951 Roswell, GA 30076 1700 Monroe Drive<br />
770-640-6088 Atlanta, GA 30324<br />
Wender & Roberts Drugs - WPF 404-872-0785<br />
1262 W Paces Ferry Rd CVS Pharmacy<br />
Atlanta, GA 30327-2320 1455 Moreland Ave Kroger Pharmacy<br />
404-237-7551 Atlanta, GA 30316 1715 Howell Mill Road<br />
404-622-1819 Atlanta, GA 30318<br />
Wender and Roberts 404-355-7889<br />
1262 W Paces Ferry Rd Rite Aid Pharmacy 11794<br />
Atlanta, GA 30327-2320 1512 Piedmont Road Northeast Faith Pharmacy Inc<br />
404-237-7551 Atlanta, GA 30324 1720 Phoenix Blvd<br />
404-876-2263 Ste 400<br />
Target Pharmacy College Park, GA 30349<br />
1275 Caroline St NE Discount Pharmacy Services 770-997-1112<br />
Atlanta, GA 30307<br />
1514 E Cleveland Ave<br />
404-260-0201 Ste 114 Walgreens #6999<br />
East Point, GA 30344<br />
173 S Main St<br />
Kroger Pharmacy 404-305-8002 Alpharetta, GA 30004<br />
12870 State Highway 9 678-297-9048<br />
Alpharetta, GA 30004<br />
CVS Pharmacy<br />
770-772-0699 1544 Piedmont Ave NE Kroger Pharmacy<br />
Atlanta, GA 30324<br />
1745 Peachtree St NE<br />
Target Pharmacy 404-892-0074 Atlanta, GA 30309<br />
13055 Highway 9 N 404-733-5515<br />
Milton, GA 30004-5137<br />
Publix Pharmacy<br />
770-225-1781 1544 Piedmont Ave NE Seniormed<br />
Atlanta, GA 30324<br />
1750 Enterprise Way<br />
Careplus CVS Pharmacy 724-742-0932 Ste 105<br />
133 Peachtree St NE Marietta, GA 30067<br />
Atlanta, GA 30303 CVS Pharmacy 770-916-1522<br />
404-522-6330 1554 N Decatur Rd<br />
Atlanta, GA 30307 Rite Aid Pharmacy 11789<br />
Publix Pharmacy 404-373-4534 1799 Briarcliff Road Northeast<br />
1380 Atlantic Drive NWste 14135 Atlanta, GA 30306<br />
Atlanta, GA 30363 Grady Memorial Hospital 404-873-3438<br />
404-873-5060 Corporation Cent<br />
1575 Northside Dr NW Bldg 400 Peachtree Hematology and<br />
CVS Pharmacy Atlanta Tech Center Suite 450 Oncology Consul<br />
1380 Woodstock Rd Atlanta, GA 30318-4235 1800 Howell Mill Rd<br />
Roswell, GA 30075 404-616-0930 Ste 775<br />
770-640-3131 Atlanta, GA 30318-2538<br />
East Point Grady Health Center<br />
Publix Pharmacy<br />
678-298-3228<br />
Pharmacy<br />
13800 N Highway 9 Suite E 1595 W Cleavland Ave Wal-Mart Pharmacy<br />
Alpharetta, GA 30004 East Point, GA 30344-2558 1801 Howell Mill Road NW<br />
770-751-1625 404-768-5917 Atlanta, GA 30318<br />
CVS Pharmacy<br />
404-352-5229<br />
Medicine Center Pharmacy<br />
13933 Alpharetta Hwy 1634 Jonesboro Rd SE CVS Pharmacy<br />
Milton, GA 30004 Atlanta, GA 30315 184 N Main St<br />
678-366-9633 404-627-5745 Alpharetta, GA 30009-3623<br />
678-297-1089<br />
Page 74<br />
2012 Advantage by Peach State Health Plan HMO SNP
List of Plan <strong>Provider</strong>s<br />
Pharmacies<br />
Fulton County cont. Pharmasouth Concord Pharmacy<br />
2235 Faulkner Rd NE 2500 Hospital Blvd<br />
Community, A Walgreens Atlanta, GA 30324-4224 Suite 300<br />
Pharmacy 404-325-9700 Roswell, GA 30076-4918<br />
1874 Piedmont Ave NE Ste 100A 770-664-5428<br />
Atlanta, GA 30324<br />
Publix Pharmacy<br />
404-733-6800 2235 Glenwood Ave Buy Rite Pharmacy Inc<br />
Atlanta, GA 30316<br />
2533 Gresham Rd SE<br />
CVS Pharmacy 404-373-3531 Atlanta, GA 30316-4100<br />
1943 Peachtree Rd 404-241-1195<br />
Atlanta, GA 30309<br />
CVS Pharmacy<br />
404-351-4932 2237 Cascade Rd SW Target Pharmacy<br />
Atlanta, GA 30311<br />
2539 Piedmont Road NE<br />
EZ Med Pharmacy 404-756-5591 Atlanta, GA 30324<br />
199 Hilderbrand Dr 404-720-1083<br />
Atlanta, GA 30328<br />
Kroger Pharmacy<br />
404-781-1800 2300 Holcomb Bridge Road CVS Pharmacy<br />
Roswell, GA 30075<br />
2555 Bolton Rd NW<br />
CVS Pharmacy 678-352-7480 Atlanta, GA 30318<br />
2020 B Campbellton Rd S W 404-355-8855<br />
Atlanta, GA 30311<br />
Publix Pharmacy<br />
404-758-4526 2325 Cheshire Bridge Rd NE Poly-Plex Pharmacy<br />
Atlanta, GA 30324<br />
2596 Donald Lee Hollowell<br />
Rite Aid Pharmacy 11793 404-638-1905 Parkway N<br />
2020 Howell Mill Road Northwest Ste B<br />
Atlanta, GA 30318-1732 Rite Aid Pharmacy 11788 Atlanta, GA 30318<br />
404-351-4448 2345 Peachtree Road 404-799-3315<br />
Atlanta, GA 30305<br />
Shepherd Apothecary 404-233-2101 Target Pharmacy<br />
2020 Peachtree Rd NW 2600 Holcomb Bridge Rd<br />
Atlanta, GA 30309-1465 CVS Pharmacy # 10043 Alpharetta, GA 30022-5305<br />
404-350-7743 235 Peachtree St NE 678-775-7621<br />
Atlanta, GA 30303-1401<br />
Market Pharmacy 404-577-4054 Forward West Professional Phcy<br />
209 Edgewood Ave 2600 Martin L King Jr Dr NW<br />
Atlanta, GA 30303 CVS Pharmacy Atlanta, GA 30311-1636<br />
404-524-8888 2350 Cheshire Bridge Rd 404-696-8330<br />
Atlanta, GA 30324<br />
Kroger Pharmacy 404-486-7289 Kroger Pharmacy<br />
2090 Dunwoody Club Dr 2685 Metropolitan Pkwy<br />
Atlanta, GA 30350 Rite Aid Pharmacy 11723 Atlanta, GA 30315<br />
770-391-9792 2350 Holcomb Bridge Road 404-209-6638<br />
Roswell, GA 30076<br />
Express Drugs 770-642-1829 Publix Pharmacy<br />
212 Edgewood Ave 270 Rucker Road<br />
Atlanta, GA 30303 Wal-Mart Pharmacy Alpharetta, GA 30004<br />
404-688-2211 2427 Gresham Road SE 770-360-5668<br />
Atlanta, GA 30316<br />
Your Pharmacy Solution 404-244-3132 Walgreens #11488<br />
2140 Peachtree Rd NW Ste 232 2711 Metropolitan Pkwy SW<br />
Atlanta, GA 30309-1316 CVS Pharmacy Atlanta, GA 30315-7913<br />
404-856-7080 2429 Martin Luther King Jr Dr 404-768-9719<br />
Atlanta, GA 30311<br />
Providence Pharmacy 404-691-3344 CVS Pharmacy<br />
216 W Broad St 2720 Metropolitan Ave<br />
Suite B Atlanta, GA 30315<br />
Fairburn, GA 30213 404-761-0375<br />
678-817-1715<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 75
Pharmacies<br />
List of Plan <strong>Provider</strong>s<br />
Fulton County cont. Kroger Pharmacy CVS Pharmacy<br />
3030 Headland Drive 3401 Nside Pkwy NW<br />
CVS Pharmacy Atlanta, GA 30311 Atlanta, GA 30327<br />
2750 Bankhead Hwy 404-344-5383 404-261-7123<br />
Atlanta, GA 30318<br />
404-794-2772 Wayfield Pharmacy Ponce Infectious Diseasse Center<br />
3050 Martin Luther King Jr Dr Pharmac<br />
D&B Unit H 341 Ponce De Leon Ave<br />
284 Hammond Dr NE Atlanta, GA 30311 Atlanta, GA 30308<br />
Sandy Springs, GA 30328-5010 404-699-9000 404-616-2466<br />
404-996-2374<br />
Rite Aid Pharmacy 11804 Kroger Pharmacy<br />
Atlantic Neurological And Spine 3055 Washington Road 3425 Cascade Rd SW<br />
Inst East Point, GA 30344 Atlanta, GA 30311<br />
285 Boulevard NE 404-767-8789 404-505-7802<br />
Ste 110<br />
Atlanta, GA 30312 Center For Pain Management Walgreens #13641<br />
904-962-2123 3193 Howell Mill Rd 35 Collier Rd NW<br />
Ste 317 Suite 100<br />
Atlanta Urological Group Atlanta, GA 30327 Atlanta, GA 30309-1613<br />
285 Boulevard NE Ste 215 404-603-9090 404-350-9772<br />
Atlanta, GA 30312-4220<br />
404-524-3082 CVS Pharmacy # 05731 Hughes Spalding Children’s<br />
3221 Peachtree Road NE Hospital Phar<br />
Publix Pharmacy Atlanta, GA 30305-2414 35 Jesse Hill Jr Dr<br />
2868 Peachtree Rd NE 404-869-3308 Atlanta, GA 30303-3032<br />
Atlanta, GA 30305 404-785-9634<br />
404-848-0336 Pride Pharmacy<br />
3280 Howell Mill Rd Washington Road Pharmacy<br />
Walgreens #9303 Suite 326 3518 Washington Rd<br />
2893 Peachtree Rd NE Atlanta, GA 30327 East Point, GA 30344<br />
Atlanta, GA 30305 404-355-3788 404-761-6488<br />
404-841-2293<br />
CVS Pharmacy<br />
Publix Pharmacy<br />
Pharmalife Atlanta 3284 Washington Rd 3535 Peachtree Road<br />
2915 Piedmont Rd Atlanta, GA 30344-5454 Atlanta, GA 30326<br />
Ste A 404-763-8405 404-848-0929<br />
Atlanta, GA 30305<br />
404-261-7775 Kroger Pharmacy Trinity Pharmacy<br />
3330 Piedmont Road NE 3565 Martin Luther King Jr Dr SW<br />
Kroger Pharmacy Atlanta, GA 30305 St<br />
3000 Old Alabama Road 404-233-9484 Atlanta, GA 30331-1711<br />
Alpharetta, GA 30022 678-705-5690<br />
770-751-7388 Walgreens #12604<br />
340 Boulevard NE Publix Pharmacy<br />
Walgreens #5760 Ste 143 3655 Cascade Rd<br />
3003 Old Alabama Rd Atlanta, GA 30312-1273 Atlanta, GA 30331<br />
Alpharetta, GA 30022 404-525-8256 404-505-2876<br />
678-566-3281<br />
ID Group of Atlanta, LLC Walgreens #10422<br />
CVS Pharmacy 340 Boulevard, NE Ste 210 3658 Roswell Rd NE<br />
3020 Windward Plz Atlanta, GA 30312 Altanta, GA 30342<br />
Alpharetta, GA 30005 404-588-4680 404-816-8464<br />
770-475-3638<br />
Northside Alpharetta Pharmacy Target Pharmacy<br />
CVS Pharmacy 3400 A Old Milton Pkwy 3660 Marketplace Blvd<br />
3030 Headland Drive Suite 140 East Point, GA 30344<br />
Atlanta, GA 30311 Alpharetta, GA 30005 404-267-0064<br />
404-346-1423 770-667-4023<br />
Page 76<br />
2012 Advantage by Peach State Health Plan HMO SNP
List of Plan <strong>Provider</strong>s<br />
Pharmacies<br />
Fulton County cont. Publix Pharmacy Rite Aid Pharmacy 11678<br />
4279 Roswell Road NE Suite 3 4830 Highway 9 North<br />
Rite Aid Pharmacy 11687 Atlanta, GA 30342 Alpharetta, GA 30004<br />
3719 Old Alabama Road 404-843-4358 770-777-0589<br />
Building 100<br />
Alpharetta, GA 30022 Publix Pharmacy Grady Memorial Outpatient<br />
770-475-8100 4305 State Bridge Road Pharmacy<br />
Alpharetta, GA 30342<br />
48-50 Coca Cola Place<br />
CVS Pharmacy 770-751-7997 Atlanta, GA 30303-3050<br />
3721 Campbellton Rd SW 404-616-4117<br />
Atlanta, GA 30331<br />
CVS Pharmacy<br />
404-344-7021 439 Highland Ave NE Publix Pharmacy<br />
Atlanta, GA 30312 4900 Highway 9<br />
Rite Aid Pharmacy 11797 404-230-9385 Alpharetta, GA 30004<br />
3725 Cascade Road Southwest 770-754-4327<br />
Atlanta, GA 30331-2105 Walgreens #5903<br />
404-699-1909 4395 Kimball Bridge Rd Kroger Pharmacy<br />
Alpharetta, GA 30022<br />
4920 Roswell Road<br />
Publix Pharmacy 678-566-3166 Atlanta, GA 30342<br />
3730 Carmia Drive SW Suite 200 404-843-3225<br />
Atlanta, GA 30331<br />
Publix Pharmacy<br />
404-346-9259 4401 Shallowford Road Rite Aid Pharmacy 11679<br />
Roswell, GA 30075<br />
4975 Windward Parkway<br />
Walgreens #7394 770-640-7742 Alpharetta, GA 30004<br />
3740 Cascade Rd SW 678-366-0472<br />
Atlanta, GA 30331 Walgreens #10265<br />
404-472-1946 4535 Roswell Rd NE Encompass Rx, LLC<br />
Atlanta, GA 30342-3100<br />
500 Bishop St NW Ste A3<br />
Target Pharmacy 404-236-0838 Atlanta, GA 30318-4380<br />
375 18th St 404-395-0043<br />
Atlanta, GA 30363 Rite Aid Pharmacy 11803<br />
678-954-4266 4540 Roswell Road Publix Pharmacy<br />
Building 100<br />
5180 Mcginnis Ferry Road<br />
CVS Pharmacy Atlanta, GA 30342 Alpharetta, GA 30005<br />
3788 Roswell Rd NE 404-257-1873 770-360-1030<br />
Atlanta, GA 30342<br />
404-261-6525 Kroger Pharmacy CVS Pharmacy<br />
4550 Jonesboro Road 520 Blvd SE<br />
Walgreens #9620 Union City, GA 30291 Atlanta, GA 30312<br />
3800 Princeton Lakes Pkwy SW 770-969-0267 404-624-0022<br />
Altanta, GA 30331-5580<br />
404-344-5158 Walgreens #9630 Wal-Mart Pharmacy<br />
4617 Jonesboro Rd 5200 Windward Parkway<br />
Camp Creek Pharmacy Union City, GA 30291 Alpharetta, GA 30004<br />
3886 Princeton Lakes Way Ste 770-969-0246 770-777-5832<br />
#180<br />
Atlanta, GA 30331 Wal-Mart Pharmacy Drug Park Pharmacy<br />
404-494-8010 4735 Jonesboro Road 5232 Old National Hwy<br />
Union City, GA 30291 College Park, GA 30349<br />
CVS Pharmacy 770-964-6036 404-593-2028<br />
3940 Jonesboro Rd<br />
Union City, GA 30291 Rite Aid Pharmacy 11721 Publix Pharmacy<br />
770-774-1161 4750 Alabama Road 5370 Campbelton Fairburn Rd<br />
Roswell, GA 30075 Fairburn, GA 30213<br />
Lambert Pharmacy 770-594-0638 770-774-3605<br />
405 Carlton Rd<br />
Palmetto, GA 30268-0767<br />
770-463-4031<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 77
Pharmacies<br />
List of Plan <strong>Provider</strong>s<br />
Fulton County cont. Kroger Pharmacy Target Pharmacy<br />
5665 Georgia Highway 9 5950 State Bridge Rd<br />
Northside Hospital Phcy at Alpharetta, GA 30004 Duluth, GA 30097<br />
Maridian Mark 770-752-5388 678-258-1000<br />
5445 Meridian Mark Rd<br />
Suite 190 Northside Hosp Phcy at Medical Target Pharmacy<br />
Atlanta, GA 30342 Twr 6000 N Point Pkwy<br />
404-459-1740 5670 Peachtree Dunwoody Alpharetta, GA 30022<br />
Atlanta, GA 30342 770-521-1788<br />
Walgreens #5898 404-459-1748<br />
5455 Lawrenceville Hwy NW Kroger Pharmacy<br />
Lilburn, GA 30097 Atlanta Cancer Care 6010 Sandy Springs Circle<br />
770-381-8582 5670 Peachtree Dunwoody Rd Ste Atlanta, GA 30328<br />
1100 404-256-2779<br />
Concord Drugs Atlanta, GA 30342<br />
550 Peachtree St NE 404-851-2368<br />
Kroger Pharmacy<br />
Ste 1450<br />
6055 Old National Highway<br />
Atlanta, GA 30308-2225 St Josephs Apothecary College Park, GA 30349<br />
404-523-4908 5671 Peachtree Dunwoody Rd NE 770-996-5488<br />
Suite 200<br />
Concord Drugs<br />
Atlanta, GA 30342-1701<br />
Walgreens<br />
5505 Peachtree Dunwoody Rd 678-843-7400<br />
6120 Old National Hwy<br />
Ste G-95 College Park, GA 30349-4482<br />
Atlanta, GA 30342-1797 Kroger Pharmacy 708-795-1295<br />
404-250-9656 570 E Crossville Road<br />
Roswell, GA 30076<br />
Wal-Mart Pharmacy<br />
Walgreens #9451<br />
770-640-2065<br />
6149 Old National Highway<br />
5510 Windward Pkwy College Park, GA 30349<br />
Alpharetta, GA 30004 CVS Pharmacy 770-994-0199<br />
678-366-0186 5740 Atlanta Hwy<br />
Alpharetta, GA 30004<br />
Chapman Drug Co Inc<br />
Concord Drugs<br />
678-366-7954<br />
615 N Central Ave<br />
5555 Peachtree Dunwoody Rd NE Hapeville, GA 30354-1917<br />
Ste G30 Publix Pharmacy 404-761-1136<br />
Atlanta, GA 30342-1710<br />
5805 State Bridge Rd<br />
404-252-3607 Duluth, GA 30097<br />
Sandy Springs Pharmacy<br />
770-813-7456<br />
6329 Roswell Rd<br />
Atlanta Ent Sinus And Allergy Atlanta, GA 30328<br />
Associates CVS Pharmacy 404-252-8165<br />
5555 Peachtree Dunwoody Road 5815 Campbelltron Rd<br />
Ste 125 Atlanta, GA 30331<br />
CVS Pharmacy<br />
Atlanta, GA 30342 404-346-4164<br />
6330 Roswell Rd<br />
404-255-2918<br />
Sandy Springs, GA 30328<br />
Westend Discount Pharmacy 404-255-2131<br />
Careplus CVS Pharmacy 587 Joseph E Lowery Blvd SW<br />
560 Amsterdam Ave Ste E Atlanta, GA 30310-1400<br />
Rite Aid Pharmacy 11722<br />
Atlanta, GA 30306 404-343-4795<br />
635 Holcomb Bridge Road<br />
404-892-9131<br />
Roswell, GA 30076<br />
Kroger Pharmacy 770-993-8980<br />
Target Pharmacy<br />
590 Cascade Road<br />
5610 Roswell Rd NE Atlanta, GA 30310<br />
Healthmart Pharmacy of Johns<br />
Atlanta, GA 30342-1102 404-756-1144<br />
Creek<br />
678-704-8121<br />
6375 Mcginnis Ferry Rd Ste 102<br />
Walgreens #6032 Alpharetta, GA 30005<br />
Publix Pharmacy 595 Piedmont Ave Ste 100 678-869-6000<br />
5630 Roswell Rd NE Atlanta, GA 30308<br />
Atlanta, GA 30342 404-347-9997<br />
404-497-9324<br />
Page 78<br />
2012 Advantage by Peach State Health Plan HMO SNP
List of Plan <strong>Provider</strong>s<br />
Pharmacies<br />
Fulton County cont. Walgreens #6204 Rite Aid Pharmacy 11790<br />
7530 Roswell Rd 891 Ponce De Leon Ave Northeast<br />
Walgreens #7395 Atlanta, GA 30350 Atlanta, GA 30306<br />
6410 W Johns Crossing 678-731-0246 404-874-0640<br />
Duluth, GA 30097<br />
770-476-9401 CVS Pharmacy CVS Pharmacy<br />
77 Hudson Plz 895 Holcomb Bridge Rd<br />
Walgreens #11102 Fairburn, GA 30213 Roswell, GA 30076<br />
6425 Roswell Rd NE 770-964-7785 770-993-0194<br />
Sandy Springs, GA 30328-3183<br />
404-236-0523 Grady Health System - Senior CVS Pharmacy<br />
Care Pharma<br />
895 Ralph Abernathy Blvd<br />
Kroger Pharmacy 80 Jesse Hill Jr Dr SE Atlanta, GA 30310<br />
6555 Sugarloaf Parkway 200 Room Gf003 404-755-1511<br />
Duluth, GA 30097 Atlanta, GA 30303-3031<br />
770-418-2398 404-616-5079<br />
Kroger Pharmacy<br />
900 Marietta Hwy<br />
Walgreens #6276 CVS Pharmacy Roswell, GA 30075<br />
6590 Sugarloaf Pkwy 842 Peachtree St NE 678-352-7497<br />
Duluth, GA 30097 Atlanta, GA 30308<br />
678-957-0011 404-892-8468<br />
Publix Pharmacy<br />
950 W Peachtree St NW<br />
Publix Pharmacy CVS Pharmacy Atlanta, GA 30309<br />
6615 Roswell Rd 8430 Holcomb Bridge Rd 404-253-3547<br />
Sandy Springs, GA 30328 Alpharetta, GA 30022<br />
404-843-4346 770-640-6576<br />
Concord Drugs<br />
960 Johnson Ferry Rd NE<br />
CVS Pharmacy # 03878 Kroger Pharmacy Ste 145<br />
680 Ponce De Leon Ave NE 8465 Holcomb Bridge Road Atlanta, GA 30342-1601<br />
Atlanta, GA 30308-1808 Alpharetta, GA 30022 404-252-2280<br />
404-892-1164 770-643-9155<br />
Wal-Mart Pharmacy<br />
Walgreens #5605 CVS Pharmacy 970 Mansell Road<br />
695 W Crossville Rd 865 N Highland Ave NE Roswell, GA 30076<br />
Roswell, GA 30075 Atlanta, GA 30306 770-641-0021<br />
770-650-1296 404-733-6089<br />
Publix Pharmacy<br />
Kroger Pharmacy West End Pharmacy 980 Birmingham Rd<br />
725 Ponce De Leon Ave 868 York Ave SW Alpharetta, GA 30004<br />
Atlanta, GA 30308 Atlanta, GA 30310 770-751-5549<br />
404-875-3009 404-758-8988<br />
CVS Pharmacy<br />
United Pharmacy Services Publix Pharmacy 9920 Jones Bridge Rd<br />
Christian City 8725 Roswell Rd Alpharetta, GA 30022<br />
7300 Lester Rd Bldg P Dunwoody, GA 30350 770-410-1755<br />
Union City, GA 30291-2328 770-640-5956<br />
770-210-5900 Publix Pharmacy<br />
Hemophilia of Georgia<br />
9925 Haynes Bridge Rd<br />
CVS Pharmacy # 8800 Roswell Rd Alpharetta, GA 30022<br />
7355 Roswell Rd NE Ste 170 770-751-7986<br />
Sandy Springs, GA 30328-1044 Atlanta, GA 30350<br />
678-579-9792 770-518-8272<br />
Wal-Mart Pharmacy<br />
Hwy 9 Commerce Blvd<br />
Publix Pharmacy Publix Pharmacy Alpharetta, GA 30004<br />
7525 Roswell Road 885 Woodstock Road Suite 100 770-475-4011<br />
Atlanta, GA 30350 Roswell, GA 30075<br />
678-443-8986 770-552-4586<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 79
Pharmacies<br />
List of Plan <strong>Provider</strong>s<br />
Gwinnett County Glory Pharmacy Inc Kroger Pharmacy<br />
1462 Montreal Rd Ste 101 1670 Highway 124<br />
Publix Pharmacy Tucker, GA 30084 Ste F<br />
1000 Peachtree Industrial Blvd 770-934-5252 Snellville, GA 30078<br />
Suwanee, GA 30024 770-985-3792<br />
770-932-4306 Kroger Pharmacy<br />
1475 Buford Drive Suburban Hematology Oncology<br />
Publix Pharmacy Lawrenceville, GA 30044 Assoc<br />
1030 Old Peachtree Rd 770-822-6595 1700 Tree Lane<br />
Lawrenceville, GA 30043 Ste 490<br />
678-442-0831 Walgreens #7502 Snellville, GA 30078<br />
1490 Pleasant Hill Rd<br />
Walgreens #7960<br />
770-979-2828<br />
Duluth, GA 30096<br />
1065 Duluth Hwy 770-921-9976 Apothecare Pharmacies Inc<br />
Lawrenceville, GA 30043<br />
1700 Tree Ln<br />
770-277-1834 Sams Pharmacy Suite 180<br />
1520 Scenic Highway<br />
Rite Aid Pharmacy 11689<br />
Snellville, GA 30078-6749<br />
Snellville, GA 30078<br />
1085 Peachtree Industrial<br />
770-979-0551<br />
770-979-2941<br />
Suwanee, GA 30024<br />
Bruce J Sabin MD<br />
770-614-2880 CVS Pharmacy 1790 Presidential Circle<br />
1525 Buford Drive<br />
Walgreens #6699<br />
Ste C<br />
Lawrenceville, GA 30043<br />
1090 Peachtree Industrial Blvd<br />
Snellville, GA 30078<br />
770-962-6117<br />
Suwanee, GA 30024<br />
770-979-8022<br />
678-546-0833 Rite Aid Pharmacy 11704 Walgreens #5899<br />
1545 Lawrenceville Highway<br />
Ingles Pharmacy<br />
181 S Clayton St<br />
Lawrenceville, GA 30044<br />
1154 Lawrenceville Hwy<br />
Lawrenceville, GA 30045<br />
770-338-2006<br />
Lawrenceville, GA 30045<br />
770-962-6599<br />
678-985-2732 Wal-Mart Pharmacy Gwinnett Pharmacy<br />
1550 Scenic Highway<br />
CVS Pharmacy<br />
1880 Braselton Hwy Ste 121<br />
Snellville, GA 30078<br />
1187 Grayson Hwy<br />
Lawrenceville, GA 30043-2877<br />
770-979-1911<br />
Lawrenceville, GA 30045<br />
770-338-1111<br />
770-338-2513 Walgreens #5896 Rite Aid Pharmacy 11701<br />
1556 Lawrenceville Hwy<br />
CVS Pharmacy<br />
1900 Duluth Highway<br />
Lawrenceville, GA 30044<br />
1190 Indian Trail<br />
Lawrenceville, GA 30043<br />
770-962-5110<br />
Norcross, GA 30093<br />
678-985-0295<br />
770-638-8958 Kroger Pharmacy Publix Pharmacy<br />
1605 Buford Highway<br />
Publix Pharmacy<br />
1905 Scenic Highway Ste 4000<br />
Buford, GA 30518<br />
1250 Tech Dr<br />
Snellville, GA 30078<br />
770-945-4077<br />
Norcross, GA 30093<br />
770-978-5806<br />
770-717-3150 Publix Pharmacy Target Pharmacy<br />
1625 Pleasant Hill Road Ste 20<br />
Yoo Pharmacy<br />
1905 Scenic Hwy N<br />
Duluth, GA 30096<br />
1299 Old Peachtree Rd<br />
Snellville, GA 30078<br />
770-806-2787<br />
Sawahee, GA 30024<br />
678-344-8223<br />
770-814-4515 United Pharmacy Services of Kroger Pharmacy<br />
Atlanta Inc<br />
Wal-Mart Pharmacy<br />
1911 Grayson Highway<br />
1626 Jeurgens Court<br />
1400 Lawrenceville Highway<br />
Grayson, GA 30017<br />
Norcross, GA 30093<br />
Lawrenceville, GA 30044<br />
770-237-5352<br />
678-533-6459<br />
770-682-5342 Walgreens #7959<br />
1930 Hwy 124<br />
Snellville, GA 30078<br />
770-972-4709<br />
Page 80<br />
2012 Advantage by Peach State Health Plan HMO SNP
List of Plan <strong>Provider</strong>s<br />
Pharmacies<br />
Gwinnett County cont. Rite Aid Pharmacy 11730 Walgreens #7958<br />
2325 Pleasant Hill Road 2630 Braselton Hwy<br />
Rite Aid Pharmacy 11724 Duluth, GA 30096 Buford, GA 30519<br />
1938 Scenic Highway 770-497-4425 678-546-0753<br />
Snellville, GA 30078<br />
770-972-6607 Walgreens #6088 Wal-Mart Pharmacy<br />
2365 Buford Dr 2635 Pleasant Hill Road<br />
CVS Pharmacy Lawrenceville, GA 30043 Duluth, GA 30096<br />
1938 Scenic Hwy N 770-339-1174 770-418-9535<br />
Snellville, GA 30078<br />
770-979-0922 Publix Pharmacy CVS Pharmacy<br />
2380 Buford Dr 2650 Cruse Rd<br />
CVS Pharmacy Lawrenceville, GA 30043 Lawrenceville, GA 30044<br />
1950 Buford Hwy 770-338-4566 770-921-8514<br />
Buford, GA 30518<br />
770-945-7286 Kmart Pharmacy3602 Kroger Pharmacy<br />
2420 Wisteria Dr 2700 Braselton Highway<br />
CVS Pharmacy Snellville, GA 30078 Dacula, GA 30019<br />
1960 E Main St 770-972-1592 770-614-1022<br />
Snellville, GA 30078<br />
770-972-4448 Publix Pharmacy Walgreens #5989<br />
2463 Hamilton Mill Pkwy 2705 Buford Hwy<br />
CVS Pharmacy Dacula, GA 30019 Duluth, GA 30096<br />
202 Grayson Hwy 770-614-1076 770-476-2551<br />
Lawrenceville, GA 30045<br />
770-963-8183 Walgreens #6638 Publix Pharmacy<br />
2500 Old Norcross Rd 2750 Buford Hwy<br />
Walgreens #7546 Lawrenceville, GA 30044 Duluth, GA 30096<br />
2075 Grayson Hwy 678-407-9131 770-622-6756<br />
Grayson, GA 30017<br />
770-338-4093 Corner Pharmacy Shinns Pharmacy<br />
2550 Pleasant Hill Rd Build 100 2790 Lawrenceville Suwanee Rd<br />
Walgreens #5990 Ste 126 Ste 150<br />
2075 Lawrencevillesuwanee Rd Duluth, GA 30096 Suwanee, GA 30024<br />
Suwanee, GA 30024 770-622-0688 770-932-3023<br />
678-377-0532<br />
Dacula Pharmacy<br />
CVS Pharmacy<br />
Kroger Pharmacy 2555 2nd Ave N 2850 Lawrenceville Suwanee Rd<br />
2100 Riverside Parkway Dacula, GA 30019 Suwanee, GA 30024<br />
Lawrenceville, GA 30043 770-339-1593 770-932-5410<br />
770-962-1197<br />
Rite Aid Pharmacy 11686 Wal-Mart Pharmacy<br />
Kroger Pharmacy 2580 Winder Highway 2912 Main St W<br />
2120 Lawrenceville Suwanee Road Dacula, GA 30019 Snellville, GA 30078-3148<br />
Suwanee, GA 30024 770-682-0213 678-344-0347<br />
770-962-1352<br />
CVS Pharmacy<br />
CVS Pharmacy<br />
Walgreens #6185 2605 Hamilton Mill Rd 2935 Five Forks Trickum Rd<br />
2220 Hewatt Rd Buford, GA 30519 Lawrenceville, GA 30044<br />
Snellville, GA 30039 678-546-5352 770-982-5202<br />
770-978-4157<br />
Target Pharmacy Rite Aid Pharmacy 11703<br />
Snells Pharmacy 2625 Peachtree Pkwy 2979 Five Forks Trickum Road<br />
2295 Oak Rd Suwanee, GA 30024 Lawrenceville, GA 30044<br />
Snellville, GA 30078 678-965-5806 770-979-8121<br />
770-972-0700<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 81
Pharmacies<br />
List of Plan <strong>Provider</strong>s<br />
Gwinnett County cont. Publix Pharmacy Kroger Pharmacy<br />
3200 Holcomb Bridge Rd 3455 Peachtree Ind Blvd<br />
Walgreens #5446 Norcross, GA 30092 Duluth, GA 30096<br />
2990 Five Forks Trickum Rd 770-417-5106 770-476-7985<br />
Lawrenceville, GA 30044<br />
770-978-9115 Target Pharmacy Walgreens #10248<br />
3205 Woodward Blvd Ste B 3505 Centerville Hwy<br />
CVS Pharmacy Buford, GA 30519-4938 Snellville, GA 30039-6405<br />
3010 Hwy 124 678-482-6528 770-736-2157<br />
Snellville, GA 30039<br />
770-736-6601 Wal-Mart Pharmacy Publix Pharmacy<br />
3245 Lawrenceville Suwanee Rd 3550 Centerville Hwy Ste 201<br />
CVS Pharmacy Suwanee, GA 30024 Snellville, GA 30039<br />
3027 Jim Moore Rd 678-482-1646 770-736-7806<br />
Dacula, GA 30019<br />
770-339-0129 Publix Pharmacy Forsyth Phcy<br />
3245 Peachtree Pkwy 3592 Old Atlanta Rd<br />
Kroger Pharmacy Suwanee, GA 30024 Ste 105<br />
3035 Centerville Highway 770-886-5341 Suwanee, GA 30024<br />
Ste 19 678-513-7473<br />
Snellville, GA 30039<br />
Wal-Mart Pharmacy<br />
770-982-1061 3250 Sardis Church Road Rite Aid Pharmacy 11729<br />
Buford, GA 30519<br />
3610 Peachtree Industrial<br />
Kroger Pharmacy 678-546-6406 Boulevard<br />
3050 Five Forks Trickum Rd Duluth, GA 30096<br />
Lilburn, GA 30047 Rite Aid Pharmacy 11695 770-476-7442<br />
770-985-3720 3295 Highway 124<br />
Snellville, GA 30039<br />
Kroger Pharmacy<br />
Wal-Mart Pharmacy 770-972-8255 3651 Peachtree Parkway<br />
3059 Lawrence Hwy Suwanee, GA 30024<br />
Lawrenceville, GA 30044 Kroger Pharmacy 770-418-2388<br />
678-259-0124 3300 Hamilton Mill Road<br />
Buford, GA 30519<br />
Village Podiatry<br />
Publix Pharmacy 770-614-1086 3655 Howell Ferry Rd<br />
3059 Lawrenceville Hwy Ste 100<br />
Lawrenceville, GA 30044 Rite Aid Pharmacy 11812 Duluth, GA 30096<br />
770-717-0090 3330 Hamilton Mill Road 770-497-8283<br />
Buford, GA 30519<br />
Kroger Pharmacy 770-904-7188 Publix Pharmacy<br />
3093 Steve Reynolds Blvd 375 Rockbridge Rd<br />
Duluth, GA 30096 Publix Pharmacy Lilburn, GA 30047<br />
770-225-0960 3370 Sugarloaf Pkway 770-806-4045<br />
Lawrenceville, GA 30044<br />
Critical Care Systems 678-376-6055 Wal-Mart Pharmacy<br />
3100 Medlock Bridge Rd Ste 335 3795 Buford Drive<br />
Norcross, GA 30071-1439 Sams Pharmacy Buford, GA 30519<br />
770-209-9728 3383 Buford Drive 770-271-9807<br />
Buford, GA 30519<br />
Publix Pharmacy 770-831-8182 Publix Pharmacy<br />
3120 Mathis Airport Pkwy 3870 Peachtree Industrial Blvd<br />
Suwanee, GA 30024 Wal-Mart Pharmacy Duluth, GA 30096<br />
770-781-4640 3435 Centerville Highway 770-813-9330<br />
Snellville, GA 30039<br />
Spectrum Healthcare Solutions 770-972-3135 Concord Pharmacy<br />
LLC<br />
3890 Johns Creek Pkwy South<br />
3151 Lenora Church Road Sams Pharmacy Ste 160<br />
Suite 600 3450 Steve Reynolds Blvd Suwanee, GA 30024<br />
Snellville, GA 30039 Duluth, GA 30096 678-417-0122<br />
678-344-0148 770-495-0484<br />
Page 82<br />
2012 Advantage by Peach State Health Plan HMO SNP
List of Plan <strong>Provider</strong>s<br />
Pharmacies<br />
Gwinnett County cont. Kroger Pharmacy Sugarloaf Pharmacy<br />
4155 Highway 29 And Beaver Run 4825 Sugarloaf Pkwy Ste B/C<br />
CVS Pharmacy Lilburn, GA 30047 Lawrenceville, GA 30044-8800<br />
3900 Lawrenceville Hwy NW 770-717-3044 770-220-7770<br />
Lilburn, GA 30047<br />
770-921-3537 Walgreens #10902 Publix Pharmacy<br />
4235 Lawrenceville Hwy NW 4840 Golden Parkway<br />
Target Pharmacy Lilburn, GA 30047-3427 Buford, GA 30518<br />
3935 Venture Drive 770-921-7074 770-614-7711<br />
Duluth, GA 30096<br />
770-476-9656 CVS Pharmacy CVS Pharmacy<br />
4358 Burns Rd 485 Peachtree Industrial Blvd<br />
Kroger Pharmacy Lilburn, GA 30047 Suwanee, GA 30024<br />
400 Peachtree Industrial Blvd 770-564-8023 678-546-0584<br />
Ste 17<br />
Suwanee, GA 30024 Walgreens #9494 Publix Pharmacy<br />
770-932-4373 4397 Sudderth Rd 4850 Sugarloaf Parkway<br />
Sugar Hill, GA 30518 Lawrenceville, GA 30044<br />
Kroger Pharmacy 678-546-8442 770-277-5246<br />
4002 Stone Mountain Highway<br />
Snellville, GA 30039 Rite Aid Pharmacy 11811 CVS Pharmacy<br />
770-979-8772 4470 Nelson Brogdon Boulevard 4860 Stone Mountain Hwy<br />
Sugar Hill, GA 30518 Lilburn, GA 30047<br />
Wal-Mart Pharmacy 770-945-7691 770-972-2846<br />
4004 Lawrenceville Hwy NW<br />
Lilburn, GA 30047 Kroger Pharmacy Southern Family Market<br />
770-921-0228 455 Highway 20 505 Bankhead Highway<br />
Lawrenceville, GA 30045 Carrollton, GA 30017<br />
Harry’s Pharmacy 770-962-3515 678-796-0605<br />
4017 Annistown Rd Ste E<br />
Snellville, GA 30039-6901 Kroger Pharmacy Kroger Pharmacy #11-635<br />
770-696-4828 457 Nathan Dean Blvd 505 Dacula Rd<br />
Dallas, GA 30093 Dacula, GA 30019-2125<br />
Publix Pharmacy 770-443-8776 678-407-8739<br />
4045 Five Forks Trickum Rd<br />
Lilburn, GA 30047 Lai Drug Company, Inc CVS Pharmacy<br />
770-381-4176 470 N Clayton St Ste 101 5095 Peachtree Parkway<br />
Lawrenceville, GA 30046-4872 Norcross, GA 30092<br />
Publix Pharmacy 770-963-1736 770-209-9299<br />
4051 Stone Mountain Hwy S<br />
Lilburn, GA 30047 Gwinnett Clinic Pharmacy Norcross Pharmacy<br />
770-972-8221 475 Philip Blvd 510 Beaver Ruin Rd<br />
Ste 100 Norcross, GA 30071-3919<br />
CVS Pharmacy Lawerenceville, GA 30045 770-448-2288<br />
4100 H Five Forks Trickum Rd 678-226-6212<br />
Lilburn, GA 30047 Walgreens #7001<br />
770-921-8071 VN Pharmacy 5296 Jimmy Carter Rd<br />
4782 Jimmy Carter Blvd Norcross, GA 30093<br />
Rite Aid Pharmacy 11706 Ste 7 770-798-9284<br />
4101 Five Forks Trickum Road Norcross, GA 30093<br />
Lilburn, GA 30047<br />
770-717-0707<br />
Accredo Health Group Inc<br />
770-381-2884 5300 Oakbrook Pkwy Ste 320<br />
McKenzie Drugs and Norcross, GA 30093<br />
CVS Pharmacy Compounding 770-935-2510<br />
4110 Pleasant Hill Rd 4814 Stone Mountain Hwy Ste 10<br />
Duluth, GA 30096<br />
Ste 10<br />
CVS Pharmacy<br />
770-418-0510 Lilburn, GA 30047<br />
5304 N Buford Hwy<br />
770-972-6050<br />
Norcross, GA 30071<br />
770-209-0296<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 83
Pharmacies<br />
List of Plan <strong>Provider</strong>s<br />
Gwinnett County cont. Walgreens #6207 Publix Pharmacy<br />
5985 Peachtree Pkwy 720 Dacula Rd<br />
CVS Pharmacy Norcross, GA 30092 Dacula, GA 30019<br />
5370 Laurel Springs Parkway 678-421-9221 770-822-6229<br />
Suwanee, GA 30024<br />
678-947-6614 Kroger Pharmacy Concord Pharmacy<br />
6001 Hwy 20 771 Old Norcross Rd<br />
Atlanta Pharmacy Sugar Hill, GA 30518 Suite 100<br />
5456 Jimmy Carter Blvd Ste 160 678-546-4113 Lawrenceville, GA 30046-4977<br />
Norcross, GA 30093-1511 678-990-8920<br />
770-807-7779 Kroger Pharmacy<br />
6050 Peachtree Pkwy CVS Pharmacy<br />
VN Pharmacy #2 Norcross, GA 30092 7734 Spalding Drive<br />
5495 Jimmy Carter Blvd Ste A8 770-449-1986 Norcross, GA 30092<br />
Norcross, GA 30093-1532 770-447-9096<br />
770-559-1831 Kroger Pharmacy<br />
6050 Singleton Rd Publix Pharmacy<br />
Rite Aid Pharmacy 11720 Norcross, GA 30093 7780 Mcginnis Ferry Road<br />
5505 Buford Highway Northwest 770-242-3344 Suwanee, GA 30024<br />
Norcross, GA 30071 770-622-2652<br />
770-441-9220 CVS Pharmacy<br />
620 W Pike St Publix Pharmacy<br />
CVS Pharmacy Lawrenceville, GA 30045 831 Auburn Rd<br />
5575 Lawrenceville Hwy 770-339-1802 Dacula, GA 30019<br />
Lilburn, GA 30047 770-682-2627<br />
770-935-4959 Wal-Mart Pharmacy<br />
630 Collins Hill Rd Johnsons Hometown Pharmacy<br />
Old Norcross Road Pharmacy Lawrenceville, GA 30045 Inc<br />
558 Old Norcross Road 770-995-5212 85 E Main St<br />
Suite 201 Buford, GA 30518<br />
Lawrenceville, GA 30045 Suburban Hematology Oncology 770-945-9501<br />
770-682-8622 Assoc<br />
631 Professional Dr Publix Pharmacy<br />
Home Choice Partners Inc Ste 450 911 Duluth Highway<br />
5600 Oakbrook Pkwy Lawrenceville, GA 30046 Lawrenceville, GA 30043<br />
Ste 170 770-963-8030 770-339-5606<br />
Norcross, GA 30093<br />
678-987-0321 Walgreens Publix Pharmacy<br />
631 Professional Dr Ste 100 930 New Hope Road<br />
CVS Pharmacy Lawrenceville, GA 30046-3367 Lawrenceville, GA 30045<br />
5710 Sugarloaf Parkway 770-339-2029 770-682-2433<br />
Lawrenceville, GA 30043<br />
770-237-2222 Primrose Pharmacy Kroger Pharmacy<br />
6330 Primrose Hill Ct Ste 103 950 Herrington Rd<br />
Walgreens #12147 Norcross, GA 30092-4544 Lawrenceville, GA 30044<br />
575 Dacula Rd 770-903-0142 770-995-6210<br />
Dacula, GA 30019<br />
770-962-2077 Rite Aid Pharmacy 11699<br />
645 Russell Road<br />
Concord Pharmacy-Q Lawrenceville, GA 30043<br />
575 Professional Drive 770-682-5512<br />
Ste 170<br />
Lawrenceville, GA 30046<br />
CVS Pharmacy<br />
770-338-0971 650 B Rock Bridge Rd<br />
Lilburn, GA 30047<br />
Publix Pharmacy 770-381-0637<br />
5885 Cumming Hwy<br />
Buford, GA 30518<br />
770-614-8866<br />
Page 84<br />
2012 Advantage by Peach State Health Plan HMO SNP
Index<br />
A<br />
Aristizabal, Jose .......... 59<br />
Armstrong, David......... 27<br />
Barlow, Richard........... 29<br />
Barlow, Richard........... 33<br />
Borders, Juel MD ........ 46<br />
Bouchard, James ........ 57<br />
Abdalla, Mazen............ 43 Arnold, William MD...... 23 Barnhill, James MD..... 25 Bouchard, James ........ 58<br />
Abdi, Zia MD ............... 12 Arp, Michelle ............... 26 Bashey, Asad MD ........ 41 Bowen, Genesis........... 44<br />
Abend, Melvin MD....... 37 Asa Yancey Health Bashir, Khalid MD........ 43 Bowen, Kristina MD..... 41<br />
Accredo Health Center Battey, Patrick MD ...... 63 Bowman, Brock........... 55<br />
Group Inc ................ 83 Pharmacy ................ 74 Baykal, Demir MD ....... 25 Bradley, Cinnamon<br />
Adeduntan, Azeez Ash, Zavier MD............ 11 Beach, Scott MD ......... 25 MD .......................... 12<br />
MD .......................... 63 Assevero, Michael ....... 18 Beal, Eddie MD............ 66 Bradley, Tajuana.......... 39<br />
Aduloju, Simbo MD...... 41 Assevero, Michael ....... 19 Beaty, Mark MD .......... 54 Bradley, Tajuana.......... 40<br />
Afshani, Victoria MD.... 40 Assevero, Michael ....... 20 Beaumont, Walter DC .. 26 Branch, James DPM.... 58<br />
Agbogu, Bob MD ......... 43 Assevero, Michael ....... 44 Bechler-Karsch, Abby.. 23 Brandt, Stephen .......... 35<br />
Aguayo, Michele MD ... 14 Assevero, Michael ....... 46 Becker, Nadine............ 46 Braswell, Precious<br />
Ahmed, Mirza.............. 22 Assevero, Michael ....... 49 Beech, Derrick............. 37 MD .......................... 19<br />
Ahmed, Mirza.............. 26 Atlanta Cancer Care .... 78 Beech, Derrick............. 62 Braswell, Precious<br />
Ajayi, Ganiat MD.......... 66 Atlanta Ent Sinus Behavioral Health MD .......................... 46<br />
Ajayi, Julius MD .......... 17 And Allergy Treatment Braunstein, Meryl<br />
Al Mulki, Mohammad .. 59 Associates............... 69 Solutions LLC......... 66 MD .......................... 23<br />
Aladesanmi, Oluranti Atlanta Ent Sinus Belachew, Yohannes.... 15 Braza, Thomas ............ 27<br />
MD .......................... 16 And Allergy Beland, Jason.............. 29 Braza, Thomas ............ 28<br />
Alder, David................. 57 Associates............... 78 Belcher, Kelvin ............ 28 Bressler, Adam............ 40<br />
Alder, David................. 58 Atlanta Family Beldick, Gary MD ........ 52 Briarcliff Pharmacy ...... 70<br />
Alexander, Joel............ 54 Physicians ............... 70 Bell, David................... 57 Brody, Jason MD......... 52<br />
Alexander, Ruben ........ 11 Atlanta Medical Bell, David................... 58 Brody, Jason MD......... 53<br />
Ali, Kareem MD ........... 11 Center ..................... 64 Bell, Meredith.............. 29 Brown, Johnny DC ...... 26<br />
Ali, Kareem MD ........... 14 Atlanta Medical Bell, Meredith.............. 30 Brown, Kevin MD ........ 35<br />
Alizadeh, Aaron ........... 41 Center ..................... 66 Bell, Meredith.............. 34 Brown, Pamela ............ 44<br />
Alizadeh, Aaron ........... 42 Atlanta Network For Bell-Carter, Denise Brown, William MD...... 24<br />
Allen, Tenecia.............. 22 Indicidual & MD .......................... 12 Bruce J Sabin MD ....... 80<br />
Allen, Tenecia.............. 26 Family Therapy........ 66 Bennett, Cecil MD ....... 12 Brummitt, Kenyetta ..... 46<br />
Allstate Pharmacy........ 69 Atlanta Pharmacy ........ 84 Benson, Elinor MD....... 46 Bruscato, Eliza............. 46<br />
Alpert, Harold MD........ 59 Atlanta Urological Bent-Harley, Sharon Buckner, Ayanna ......... 16<br />
Ambroze, Wayne ......... 27 Group ...................... 76 MD .......................... 46 Burgin, Janice ............. 45<br />
Amerson, James MD... 29 Atlantic Neurological Benton, James ............ 60 Burke, Michael MD...... 66<br />
Amerson, James MD... 33 And Spine Inst......... 76 Benton, James ............ 61 Burkle, Jaime .............. 24<br />
Anachebe, Ngozi MD... 46 Attaway, Dean............. 14 Benton, James ............ 62 Burton, Charles MD..... 47<br />
Anchor Hospital ........... 64 Ausborn Behavioral Berenson, Eric............. 62 Buy Rite Pharmacy<br />
Anchor Hospital ........... 66 Care PC.................. 66 Berenson, Frank .......... 43 Inc........................... 75<br />
Anderson, David MD.... 16 Austin-Harris, Corliss... 57 Berenson, Frank .......... 44 Byrd, Eileen DPM ........ 58<br />
Anderson, David .......... 33<br />
Anderson, James......... 54 B<br />
Bergh, Mary MD.......... 25<br />
Bills, Elbridge MD........ 46<br />
C<br />
Anderson, William ....... 11 Babalola, Cecilia MD ... 17 Bilsky, Gerald .............. 55 C & S Healthcare Inc... 72<br />
Anderson, William ....... 14 Babalola, Dolapo MD... 12 Blake, Victor MD ......... 16 Cain, Thomas .............. 57<br />
Andrews, Andrea MD .. 11 Babalola, Olufemi DO .. 37 Blank, Stephen MD ..... 19 Cain, Thomas .............. 58<br />
Andrews, Andrea MD .. 14 Badnin, Martha............ 41 Boaten, Afua................ 12 Callaway, Juaquita<br />
Andrews, Andrea MD .. 15 Baeten, Robert PA-C.... 22 Boden, Milton .............. 40 MD .......................... 45<br />
Andrews, Valisia MD.... 18 Balistreri, Anthony ....... 35 Bonaccorsi, Paola Camasta, Craig DO...... 58<br />
Anegundi, Sudhindra Balk, Michael MD........ 23 MD .......................... 28 Cameron, Nadia MD .... 14<br />
MD .......................... 63 Ball Lupa, Julia ........... 49 Bonk, Catherine........... 44 Camp Creek<br />
Anthony, Charmaine .... 39 Bao, Christine.............. 14 Bonk, Catherine........... 49 Pharmacy ................ 77<br />
Apothecare<br />
Bapat, Amol MD .......... 23 Booker-Roberts, Campbell, Mary MD..... 49<br />
Pharmacies Inc ....... 69 Bapat, Amol................. 23 Karla ....................... 12 Careplus CVS<br />
Apothecare<br />
Baptiste, Philip MD...... 28 Booker-Roberts,<br />
Pharmacy ................ 74<br />
Pharmacies Inc ....... 80 Baptiste, Philip MD...... 29 Karla ....................... 19 Careplus CVS<br />
Apple, David................ 54 Barber, Julie MD ......... 28 Bordenca, Mark........... 52 Pharmacy ................ 78<br />
Apple, David................ 55 Barclay, Charles .......... 11 Bordenca, Mark........... 53 Caring Pharmacy ......... 71<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 85
Index<br />
Carlin, David MD ......... 53 Cohen, Mark................ 24 CVS Pharmacy............. 77 Derossett, Sarah.......... 43<br />
Carltons Dunwoody Colac, Olga RN ............ 14 CVS Pharmacy............. 78 Desai, Rohit MD .......... 11<br />
Pharmacy ................ 72 Colbert, Laronna.......... 40 CVS Pharmacy............. 79 Deutsch, Mark............. 57<br />
Carmichael, Colbert, Laronna.......... 41 CVS Pharmacy............. 80 Dew, James ................ 51<br />
Stephanie................ 45 Cole, Harvey MD ......... 52 CVS Pharmacy............. 81 Diamond, Andrew<br />
Carmichael, Colliers Personal CVS Pharmacy............. 82 MD .......................... 54<br />
Stephanie................ 49 Care Pharmacy........ 71 CVS Pharmacy............. 83 Diamond, Ivan ............. 47<br />
Carr, Daniel MD........... 41 Colliers Pharmacy........ 72 CVS Pharmacy............. 84 Diaz, Ruben BS ........... 55<br />
Carter, John ................ 18 Comfort Pharmacy 2 ... 72 CVS Pharmacy #.......... 79 Diaz, Ruben BS ........... 56<br />
Carter, Richard ............ 39 Community, A CVS Pharmacy # Dickensheets, David<br />
Carter, Richard ............ 40 Walgreens 03878 ..................... 79 MD .......................... 40<br />
Carter, Ursula .............. 49 Pharmacy ................ 75 CVS Pharmacy # DiFrancesco, Lisa<br />
Castellano, Bradley...... 58 Concord Drugs ............ 73 05731 ..................... 76 MD .......................... 57<br />
Center For Pain Concord Drugs ............ 78 CVS Pharmacy # Disantis, Dennis .......... 35<br />
Management ........... 76 Concord Drugs ............ 79 10043 ..................... 75 Disch, Steven MD........ 44<br />
Chacko, Thomas MD ... 22<br />
Chaliff, Michael MD..... 28<br />
Concord Pharmacy ...... 75<br />
Concord Pharmacy ...... 82 D<br />
Discount Pharmacy<br />
LLC ......................... 72<br />
Chaliff, Michael MD..... 30 Concord Pharmacy ...... 84 D&B............................. 76 Discount Pharmacy<br />
Chaliff, Michael MD..... 34 Concord Pharmacy-Q .. 84 D’heurle, David MD ..... 52 Services .................. 74<br />
Champney, Michael..... 36 Conduah, Augustine Dacula Pharmacy ........ 81 Dixon, Martin............... 11<br />
Chandora, MD .......................... 54 Dailey, Michael MD ..... 40 Dopson, James MD..... 18<br />
Madhusudan MD..... 15 Conley, Michael MD .... 66 Dania, Frank MD ......... 11 Dorsey, Anthony .......... 23<br />
Chandra, Sandeep....... 22 Cooley, June PSYD...... 67 Daniels, Elvan MD ....... 12 Dorsey, Anthony .......... 25<br />
Chapman Drug Co Coolidge, Mary Daniels, Elvan.............. 12 Dorsey, Anthony .......... 26<br />
Inc........................... 78 Katherine LCSW ...... 67 Danner, Omar.............. 37 Dotson, Sybil ............... 23<br />
Charkawi, Ahmad Cooper, Donna PA-C.... 54 Danner, Omar.............. 62 Dott, Andrew MD......... 47<br />
MD .......................... 12 Coralli, Richard............ 22 Dansby, Davina ........... 11 Dourron, Robert MD .... 45<br />
Charlton, Julie CNM .... 47 Coralli, Richard............ 23 Dansby, Davina ........... 14 Dourron, Robert........... 45<br />
Charlton, Julie CNM .... 49 Corner Pharmacy......... 81 Datoc, Patrick.............. 30 Dourron, Rodney MD... 45<br />
Charukhchian, Cox, Gregory ............... 27 Datoc, Patrick.............. 34 Drayton, Joyce MD...... 40<br />
Samvel MD.............. 35 Crawford, Marvin MD .. 16 Daus, Kevin ................. 18 Dretler, Robin .............. 40<br />
Chen, Jack .................. 24 Crenshaw, Yvonka Daus, Kevin ................. 20 Drug Park Pharmacy ... 77<br />
Chiang, Grace MD ....... 22 MD .......................... 18 Davis Williams, E MD .. 19 Duncan, Thomas ......... 38<br />
Childs, Ed MD ............. 37 Crenshaw, Yvonka Dawson, Felicia ........... 47 Duncan, Wallace MD ... 15<br />
Childs, Gwendolyn MD .......................... 19 Daya, Shashikant ........ 12 Dunson Allen,<br />
PhD ......................... 67 Crenshaw, Yvonka Daya, Shashikant ........ 44 Shelley MD.............. 19<br />
Choat, Dennis.............. 27 MD .......................... 45 Deimler, Robert ........... 14 Dunwoody<br />
Christian Counseling Crenshaw, Yvonka DeKalb Grady Health Psychology Inc....... 66<br />
And Psychological MD .......................... 47 Center<br />
Dunwoody Urgent<br />
Services .................. 66 Critical Care Systems .. 82 Pharmacy ................ 69 Care ........................ 69<br />
Christie, Jacqueline Critz, Frank.................. 60 DeKalb Health<br />
Durrett, Donald............ 30<br />
MSN........................ 11 Critz, Frank.................. 61 Pharmacy ................ 69<br />
Christie, Jacqueline Critz, Frank.................. 62 E<br />
DeKalb medical<br />
MSN........................ 12 Crone, William MD ...... 19 Center at East Point Grady<br />
Chung, Eun Connie...... 62 Crone, William MD ...... 20 Hillandale ................ 64 Health Center<br />
Clark, Jeffrey MD ........ 24 Crowe, Michael MD..... 19 DeKalb Medical Pharmacy ................ 74<br />
Clark, Michael MD....... 63 Cunningham, Kirstie Center ..................... 64 Egbe, Patrick ............... 24<br />
Cleveland, William MD .......................... 47 Delaney, Sean MD....... 25 Ehirim, Princewill MD .. 44<br />
MD .......................... 42 CVS Pharmacy............. 69 Delgrosso Burt, Ehrlich, Jonathan MD .. 19<br />
Cleveland, William CVS Pharmacy............. 70 Cassie ..................... 40 Elgammal, Nahed<br />
MD .......................... 43 CVS Pharmacy............. 71 Delta Employee Care MD .......................... 49<br />
Clopton, Charles MD.... 11 CVS Pharmacy............. 72 Pharmacy ................ 73 Elhammali, Balsam<br />
Clopton, Charles MD.... 12 CVS Pharmacy............. 73 Demarini, Thomas ....... 59 MD .......................... 16<br />
Coe, Susan MD ........... 35 CVS Pharmacy............. 74 Demarini, Thomas ....... 60 Elks, Martha MD.......... 16<br />
Coe, Susan.................. 36 CVS Pharmacy............. 75 Denmark, David DC..... 26 Ellis, Reuben ............... 43<br />
Coffsky, Jay................. 28 CVS Pharmacy............. 76 Derosa, Michael MD.... 53 Ellison, Margarett ........ 39<br />
Page 86<br />
2012 Advantage by Peach State Health Plan HMO SNP
Index<br />
Elmore, Kathryn........... 42 Franklin, Cheryl MD..... 47 Glory Pharmacy Inc ..... 80 Gul, Rahim .................. 14<br />
Elmore, Kathryn........... 43 Fransua, Mesfin MD .... 16 Gober, Henry MD......... 19 Gullick, Richard MD..... 44<br />
Elsey, James MD......... 38 Frederick, Hughan Gober, Henry MD......... 21 Guy, Thomas MD......... 62<br />
Elston, Sigrid PhD........ 67 MD .......................... 45 Golden Living - Guydon, Linda MD....... 22<br />
Emelife, Charmaine ..... 43 Frederick, Hughan Briarwood................ 65 Gwinnett Clinic<br />
Encompass Rx, LLC..... 77 MD .......................... 47 Golden Living Center Pharmacy ................ 83<br />
Entrekin, Kay............... 45 Frederick, Hughan Decatur ................... 65 Gwinnett Medical<br />
Entrekin, Kay............... 49 MD .......................... 49 Golden Living Center Center - Duluth ....... 64<br />
Erickson, Eric .............. 28 Freeman, Kevin MD..... 52 Glenwood ................ 65 Gwinnett Medical<br />
Evans, Candice............ 17 French, James MD ...... 54 Golden Living Center Center ..................... 64<br />
Express Drugs ............. 75 Friedland, Lance MD ... 24 Medical Arts............ 65 Gwinnett Pharmacy ..... 80<br />
Eyzaguirre, William<br />
MD .......................... 15<br />
Friedland, Lance MD ... 25<br />
Friedman, Michael<br />
Golden Living Center<br />
Northside................. 65 H<br />
Eyzaguirre, William MD .......................... 62 Goldklang, Gerald H’Doubler, Peter MD.... 63<br />
MD .......................... 17 Frist, Michael MD ........ 35 MD .......................... 41 Hackney, Wendell<br />
EZ Med Pharmacy ....... 75 Fuller, Thomas MD...... 30 Goldklang, Gerald MD .......................... 19<br />
Fulp, Charles ............... 30 MD .......................... 42<br />
F<br />
Hadley, Phillip MD ....... 18<br />
Fung, Yun MD.............. 19 Goldstein, Marvin Hafeez, Abdul .............. 28<br />
Faith Pharmacy Inc...... 74 Furtner, Jane LCSW .... 67 PhD ......................... 67 Hafeez, Nabeel MD...... 24<br />
Falcon, Hugo MD......... 28 Goodman, Cynthia ....... 45<br />
G<br />
Haggerty, Staci PA-C... 57<br />
Falcon, Hugo MD......... 30 Gordon, Akil MD .......... 36 Hajjaji, Sarah CNM ...... 47<br />
Falcon, Hugo MD......... 34 Gallaway, Dorothy Gorokhov, Mikhail Hamidi, Haleh MD ....... 49<br />
Family Practice of CFNP....................... 12 MD .......................... 11 Hanes, Timothy ........... 30<br />
Atlanta LLC.............. 69 Gallups, Jeffrey MD..... 54 Gorokhov, Tatyana Hanna, Soheil .............. 30<br />
Faulkner, Linda NP ...... 11 Gamble, Kendra........... 45 MD .......................... 11 Hanna, Soheil .............. 34<br />
Feeman, Mark ............. 55 Gangasani, Goyco, Maria ............... 11 Hardcastle, William...... 36<br />
Feiner, Clifford MD ...... 30 Sreenivasula MD ..... 25 Goyco, Maria ............... 13 Hardtman, Pandora<br />
Feiner, Clifford MD ...... 34 Gann, Joyce ................ 38 Grace Point<br />
CNM........................ 47<br />
Fern, David.................. 36 Gann, Joyce ................ 39 Counseling<br />
Harish, Dwarakinath<br />
Fernando, Nishan Gardner, Colleen NP .... 38 Associates LLC....... 66 MD .......................... 43<br />
MD .......................... 40 Gardner, Colleen NP .... 39 Grady Health System Harjee, Gulshan........... 15<br />
Feuer, Gerald............... 39 Gardner, Colleen.......... 38 - Senior Care Harp, Djana MD........... 19<br />
Fielder, Judy CNM....... 47 Gargus, John MD ........ 60 Pharma ................... 79 Harp, Jamil MD ........... 19<br />
Figa, Daryl................... 55 Gargus, John MD ........ 61 Grady Memorial Harper, Kenneth MD.... 11<br />
Figa, Daryl................... 56 Gargus, John MD ........ 62 Hospital<br />
Harris, John MD .......... 16<br />
Figueroa, Amy ............. 30 Garrett, Stephanie Corporation Cent ..... 74 Harris, Rachel MD ....... 24<br />
Finan, Marian MD........ 28 MD .......................... 16 Grady Memorial Harris, Robert .............. 54<br />
Fine, Mindy ................. 45 Garrett, Veronica MD ... 45 Outpatient<br />
Harris, Shirley.............. 35<br />
Fleming, Jacob............ 28 Gayle, Wezyann........... 14 Pharmacy ................ 77 Harrison, Harold .......... 35<br />
Fleming, Jacob............ 30 Gbadehan, Grant, Anne PA............ 11 Harry’s Pharmacy........ 83<br />
Flenaugh, Eric MD....... 27 Olanrewaju MD ....... 35 Grant, Jacqueline MD.. 19 Hasan, Rana................ 59<br />
Ford, Marsha CNM ...... 47 Geary, Franklyn MD..... 19 Grattan Smith, John .... 30 Hasan, Rana................ 60<br />
Foreman, Charles ........ 30 Geltz, Christian ............ 18 Green, Arthur DO......... 15 Hassanali, Amina......... 13<br />
Foreman, Marilyn MD.. 16 Genesys Pediatrics ...... 72 Green, Arthur DO......... 16 Hayat, Khalid MD ........ 25<br />
Forsyth Phcy................ 82 Gerber, Alan MD.......... 49 Green, Rona DPM........ 58 Hayes, Laura ............... 30<br />
Fortson, James MD ..... 54 Ghaffari, Saman DO..... 56 Gregory, Jimmy DPM .. 57 Hayles-Patterson,<br />
Forward West Ghazi, Bahair............... 57 Gregory, Jimmy DPM .. 58 Jacquline MD .......... 49<br />
Professional Gibbert, Tiffany PA-C... 54 Griffin, Kerry................ 49 Hayles-Patterson,<br />
Phcy ........................ 75 Gilbert, Stewart ........... 28 Griffith, Patrick MD...... 44 Jacquline MD .......... 50<br />
Foster, Jacquelyn ........ 37 Gilbert, Stewart ........... 30 Gross, Gail MD ............ 38 Haynes, Nicole............. 38<br />
Foster-Penn, Nancy Gilbert, Stewart ........... 34 Grossman, Clifford....... 28 Haynes, Nicole............. 39<br />
LCSW ...................... 67 Gilbert, Stewart ........... 41 Grossman, Clifford....... 41 Hays, James MD ......... 52<br />
Fotzeu, Claudia MD ..... 16 Glasser, Gary............... 45 Guan, Shangbo MD ..... 16 Head, Delphanie MD.... 13<br />
Franco, Carlos MD, Glasser, Gary............... 49 Guercio, Cynthia Healthmart Pharmacy<br />
MPH ........................ 40 Global Pharmacy ......... 72 CNM........................ 47 of Johns Creek........ 78<br />
Franco, Ned MD .......... 63 Glodener, Mark MD ..... 12 Guffin, Thomas MD ..... 55<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 87
Index<br />
Hebblewhite, Mary ID Group of Atlanta, Kakkar, Aman MD ....... 24 Kroger Pharmacy......... 80<br />
PhD ......................... 67 LLC ......................... 76 Kallanos, George ......... 31 Kroger Pharmacy......... 81<br />
Heiman, Harry MD....... 13 Ihenacho, Nicholas Kallman, Douglas MD.. 31 Kroger Pharmacy......... 82<br />
Helfman, David DO...... 58 MD .......................... 42 Kallman, Douglas MD.. 34 Kroger Pharmacy......... 83<br />
Heller, Louis MD.......... 25 Inayat, Shah MD.......... 17 Kalmin, Bruce MD ....... 35 Kroger Pharmacy......... 84<br />
Hemophilia of Incorvati, Dennis DO.... 24 Kalu, Uchenna ............. 15 Kroger Pharmacy<br />
Georgia.................... 79 Ingles Pharmacy.......... 80 Kamean, Jeffrie........... 35 #11-635.................. 83<br />
Henderson, Philip ........ 63 Ioachimescu, Adriana .. 35 Karlin, Scott MD .......... 55 Krolikowski, Edward<br />
Henderson, Vernon Iqbal, Khalid MD.......... 43 Kasow, Glenn .............. 63 DC........................... 26<br />
MD .......................... 37 Ivonye, Chinedu MD .... 16 Kassam, Gulzar ........... 18 Kron, Eric DPM............ 58<br />
Henderson, Zsakeba<br />
MD .......................... 47 J<br />
Kassam, Gulzar ........... 19<br />
Katz, Ian...................... 36<br />
Kwon, Yong PA ............ 11<br />
Kwon, Yong PA ............ 14<br />
Hendrix, Vernon MD .... 28 Jackson, Harold........... 59 Kayler, Amy CNM ........ 47<br />
Hendrix, Vernon MD .... 30 Kayler, Amy CNM ........ 50 L<br />
Jackson, Harold........... 60<br />
Hendrix, Vernon MD .... 31 Jacobson, Michael....... 51 Kazi, Moinuddin........... 13 Lai Drug Company,<br />
Hendrix, Vernon MD .... 34 Jacobson, Michael....... 52 Kelsey- Harris, Riba Inc........................... 83<br />
Henriques-Forsythe, Jacquez, Fanny ........... 44 MD .......................... 13 Lai, Yin-Lok MD........... 51<br />
Marshaleen MD....... 59 James, Mylene............ 41 Kennedy, John ............ 36 Lambert Pharmacy ...... 77<br />
Henson, Chelsea NP.... 45 James, Mylene............ 42 Khajavi, Kaveh............. 44 Lampert, Scott............. 51<br />
Henson, Chelsea NP.... 50 Jean-Gilles, Marc ........ 50 Kid & Teens Primary Lampert, Scott............. 52<br />
Heritage Medical Jeffries, Barry.............. 31 Healthcare PC ......... 70 Lampert, Scott............. 53<br />
Solutions ................. 66 Jeffries, Barry.............. 41 Kim, Chang-Soo MD.... 14 Langford, David MD .... 62<br />
High, Eric..................... 35 Jeon, Won CNM .......... 19 Kim, Jinahn MD........... 17 Laremont, Benjamin<br />
Hindash, Osama MD.... 66 Joffe, Alan MD ............ 19 Kim, Sun-Hee MD ....... 38 MD .......................... 14<br />
Hixson, Gordon............ 28 Johnson, Alan MD ....... 31 Kims Pharmacy Inc...... 72 Laremont, Sylvia.......... 50<br />
Hixson, Gordon............ 29 Johnson, Alan MD ....... 34 Kirchner, Kevin............ 60 Larrivey, Roberto MD... 55<br />
Hoffman, Joel MD ....... 55 Johnson, Caryn ........... 45 Kirschbaum, Paul ........ 23 Laskey, Gary ............... 29<br />
Holladay, David MD..... 60 Johnson, Charles......... 16 Kmart<br />
Latif, Mariam MD ........ 13<br />
Holloway, Kelvin MD.... 22 Johnson, Elizabeth Pharmacy3602 ........ 81 Latif, Rhonda MD ........ 19<br />
Holmes, Leslie............. 61 PA-C........................ 60 Kmart<br />
Lawhead, Raymond..... 39<br />
Holmes, Leslie............. 62 Johnson, Kathleen....... 18 Pharmacy4451 ........ 72 Lee, Arthur .................. 62<br />
Home Choice Johnson, Khadeja Knight, Stephen........... 51 Lee, Eugene ................ 31<br />
Partners Inc............. 84 MD .......................... 16 Kobe, Elizabeth............ 45 Lee, Eugene ................ 34<br />
Horney, John MD ........ 35 Johnson, Samuel MD .. 15 Koh, Sean.................... 51 Lee, Joon Nam MD ..... 17<br />
Houssami, Yazan ......... 44 Johnson, Traci MD ...... 50 Koh, Sean.................... 52 Lee, Steven MD........... 66<br />
Howard, Ernest............ 56 Johnson, Vanita DPM .. 57 Koh, Sean.................... 53 Lee, Yoon .................... 35<br />
Howard, Jeffrey........... 23 Johnson, Vanita DPM .. 58 Kohlhagen, Laura ........ 50 Leff, Stephen............... 51<br />
Howard, Jeffrey........... 62 Johnsons Hometown Kopelman, Harry MD ... 24 Leff, Stephen............... 53<br />
Hsiao, Clement MD...... 19 Pharmacy Inc .......... 84 Korotkin, Jeffrey .......... 47 Leff, Steven MD .......... 52<br />
Hudson, Richard.......... 13 Jones, Corron DC ........ 26 Korotkin, Jeffrey .......... 50 Leff-Goldstein, Gayle ... 51<br />
Hughes Spalding Jones, Frank MD ......... 37 Kovalczyk, William Leff-Goldstein, Gayle ... 53<br />
Children’s Hospital Jones, Tyndal MD........ 50 MD .......................... 58 Leguizamo, Jorge........ 42<br />
Phar ........................ 76 Jones-Bailey, Alise Kramer, Alan ............... 62 Lembo, Nicholas MD ... 24<br />
Humphrey, Florence MD .......................... 19 Kramer, Andrew MD.... 38 Lemon, Tracey MD ...... 19<br />
MD .......................... 27 Joseph, Grantley.......... 15 Krebs, Henry ............... 31 Lemon, Tracey MD ...... 47<br />
Humphrey, Lizabeth .... 29 Joshi, Ajay MD ............ 29 Kroger Pharmacy......... 69 Lemon, Tracey MD ...... 48<br />
Humphrey, Lizabeth .... 31 Joshi, Asmita MD ........ 13 Kroger Pharmacy......... 70 Lesesne, Joseph MD... 42<br />
Hussain, Hina MBBS.... 13 Joshi, Asmita MD ........ 14 Kroger Pharmacy......... 71 Leslie, Donald.............. 56<br />
Hutchings, Forrest Joshi, Biren ................. 43 Kroger Pharmacy......... 72 Leslie, Yvette............... 54<br />
PhD ......................... 67 Julius, Steven.............. 60 Kroger Pharmacy......... 73 Lesser, Laurence MD .. 25<br />
Hutchinson, William..... 18 Kroger Pharmacy......... 74 Levarity-Conley,<br />
Huynh, Minh MD ......... 15 K<br />
Kroger Pharmacy......... 75 Kristy....................... 11<br />
Hwang, Steve MD........ 37 Kroger Pharmacy......... 76<br />
Kadree, Margaret MD.. 16 Levengood, Gary MD... 54<br />
Kroger Pharmacy......... 77<br />
I<br />
Kaelin, Darryl............... 56 Levin, Jay MD ............. 27<br />
Kroger Pharmacy......... 78<br />
Kaila, Pramod.............. 29 Levitt, Brian................. 45<br />
Ibraheem, Musibau...... 11 Kroger Pharmacy......... 79 Levitt, Brian................. 50<br />
Page 88<br />
2012 Advantage by Peach State Health Plan HMO SNP
Index<br />
Levy, Jason MD........... 31 Marder, Sara MD......... 48 Menchion, Kenneth Movagharnia,<br />
Levy, Jason MD........... 34 Marder, Sara MD......... 50 MD .......................... 63 Faramarz MD .......... 57<br />
Lewis, Joyce ............... 11 Marine, Christopher Meng, Yuan-Xiang ....... 13 Muhammad, Angela<br />
Li, Hong....................... 11 MD .......................... 20 Merlin, Mark................ 60 MD .......................... 14<br />
Lieberman, Richard Market Pharmacy ........ 75 Merlin, Mark................ 61 Muhammedi,<br />
MD .......................... 54 Marmer, Robert MD..... 52 Merlin, Mark................ 62 Muhammed MD ...... 43<br />
Lin, James MD............ 13 Marsh, Nathan PA-C.... 54 Metro Behavioral Mulick, Arthur.............. 29<br />
Lin, John ..................... 56 Martin, Michelle MD.... 48 Care ........................ 66 Mulick, Arthur.............. 31<br />
Lipscomb-McDaniel, Martin, Paul MD .......... 40 Metta International Mulick, Arthur.............. 34<br />
Kim MD................... 20 Martinez-Barnes, Pharmacy ................ 72 Mulick, Arthur.............. 44<br />
Lipscomb-McDaniel, Maria FNP ............... 11 Meyer-Carper, Mulligan, Susan........... 31<br />
Kim MD................... 21 Martiny, Stephen......... 13 Jennifer................... 46 Murad, Emma.............. 27<br />
Lipscomb-McDaniel, Marxer, Frank MD ....... 24 Meyer-Carper, Muro, Karen ................ 42<br />
Kim MD................... 48 Maske, Allyson MD...... 57 Jennifer................... 50 Muro, Karen ................ 43<br />
Lipscomb-McDaniel, Mathers, Michael MD .. 54 Middleton, Courtney .... 50 Murphy, Brent MD....... 52<br />
Kim ......................... 20 Matthews, Leslie MD... 37 Midha, Raju MD .......... 11 Murphy, Douglas MD... 62<br />
Lipsitt, Michael............ 25 Matthews, Roland Miles, Andrea MD........ 15 Murphy, Saied MD....... 42<br />
Little, Stephen ............. 31 MD .......................... 20 Miller Thrashe, Murphy, Saied MD....... 43<br />
Littlejohn Consulting<br />
& Psychological<br />
Matzkin, Dennis MD .... 52<br />
Mauldin, Damon .......... 27<br />
Melinda ................... 20<br />
Miller, Andrea.............. 56 N<br />
Services LLC ........... 66 Mauldin, Damon .......... 28 Miller, David ................ 56 Nagaddya, Lillian......... 15<br />
Littlejohn, Eugia PhD ... 67 Maxa, Leela MD .......... 61 Miller, John ................. 51 Naiden, Vintonne ......... 46<br />
Lloyd, Patricia MD ....... 16 Mayer, Raoul MD......... 27 Miller, John ................. 52 Nam, Na Kyoung<br />
Loring, Sherrill MD ...... 44 Mbaezue, Nkechi MD .. 16 Mines, Craig MD ......... 54 Judy MD ................. 22<br />
Lovelady, Alecia MD.... 38 McAlvany, Joanne ....... 27 Minnis, Jamil MD ........ 20 Narayani,<br />
Lowery, Jolene MD ..... 35 McAlvany, Joanne ....... 28 Mittenthal, Mark MD ... 37 Ramachanran<br />
Loyd, Richard .............. 39 McBrayer Sr, Daniel .... 20 Mobbs, Mary ............... 60 MD .......................... 24<br />
Loyd, Richard .............. 40 McBrayer Sr, Daniel .... 48 Modugno, Robert MD .. 48 Narayani,<br />
Loyd, Richard .............. 41 McCampbell, Mojcik, Michael MD..... 50 Ramachanran<br />
Loyd, Richard .............. 42 Elizabeth PhD.......... 67 Molina, Adolfo MD....... 11 MD .......................... 25<br />
Lucarelli, Kristina......... 36 McClees, Rita .............. 31 Momin, Musharaf Nariani, Sanjay MD...... 17<br />
Lue, John .................... 20 McCluskey, Paul MD ... 57 MD .......................... 15 Nash, Marshall ............ 43<br />
Luster, Karen............... 16 McClusky III, David...... 36 Monett, Robert ............ 11 Nassar, Gabriel MD ..... 20<br />
Lyman, Jennifer........... 45 McClusky III, David...... 37 Montgomery, Gary....... 24 Nathanson, Avery ........ 59<br />
Lyman, Jennifer........... 50 McCord, Mark MD....... 61 Montgomery, Gary....... 62 Neish, Ariane............... 31<br />
McCoy, James BS ....... 37 Montgomery-Rice,<br />
M<br />
Nelson, Camille ........... 23<br />
McElveen, Tracy MD.... 61 Valerie MD............... 48 Newfield, Daren MD .... 54<br />
Macheers, Steven McGahan, Thomas Moomey, Charles MD.. 38 Newman, Stuart MD.... 52<br />
MD .......................... 62 MD .......................... 36 Moore, Bradley MD ..... 20 Newport Integrataed<br />
Machuta-Fernandes, McIntosh, Thomas....... 31 Moore-Ruffin, Jada Behavioral Health<br />
Shelley MD.............. 61 McIntosh, Thomas....... 34 MD .......................... 11 Inc........................... 66<br />
Macik, Paul MD........... 37 McKean, Lawrence Moore-Ruffin, Jada Newport Integrated<br />
Mack, Dominic MD...... 13 MD .......................... 22 MD .......................... 13 Behavioral<br />
Mack, Edward ............. 16 McKenzie Drugs and Moore-Waters, Sondi Healthcare Inc ......... 66<br />
Mackay, Gregory ......... 56 Compounding .......... 83 MD .......................... 12 Ngeny, Geoffrey MD .... 16<br />
Makim, Shripal MD...... 66 McKinneys<br />
Morrow, Shaunna Nguyen, Hieu............... 40<br />
Malave, Hector MD...... 24 Apothecary Inc ........ 69 MD .......................... 26 Nguyen, Kimberly<br />
Malloy, Tyrone MD ...... 38 McKune, Kelly CNM..... 50 Morton Acker, Terrie MD .......................... 14<br />
Mamby, Celia .............. 39 McMillan, Ian............... 41 MD .......................... 12 Nguyen, Paul ............... 17<br />
Mamby, Celia .............. 40 McNatt, Joshua MD..... 13 Moseri, John MD......... 66 Niaz, Saira................... 12<br />
Mandeville, Lisa .......... 45 Medbery, Robena Moss, Steven............... 31 Nichols, Michelle MD... 13<br />
Mandeville, Lisa .......... 50 MD .......................... 61 Moss, Steven............... 34 Nicol, Mark.................. 32<br />
Manga, Mercy ............. 50 Medicine Center Most, Daniel MD.......... 57 Nicol, Mark.................. 34<br />
Manlove-Simmons, Pharmacy ................ 74 Motta-Murray, Sheryl .. 17 Nieves, Rafael MD....... 14<br />
Kris MD................... 11 Meli, Richard MD......... 31 Mousa, Mousa MD ...... 24 Nimako, Juliet MD....... 12<br />
Mann, Linda ................ 13 Meli, Richard MD......... 34<br />
Nixon, Kathleen MD..... 32<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 89
Index<br />
Nixon, Kathleen MD..... 34 Ostrow, Todd............... 34 Piper, Jennifer............. 40 Raizes, Elliot MD ......... 40<br />
Norcross Pharmacy ..... 83 Ouanounou, Serge....... 44 Pirtle, Ronald MD ........ 13 Raja, Mukund MD........ 55<br />
Norris, Cheryl .............. 42<br />
Norris, Shannon........... 32 P<br />
Plummer, Valens MD... 13<br />
Poindexter, James<br />
Ramamurthy, Suresh... 22<br />
Ramirez, Raymond<br />
Norris, Shannon........... 34 Palasis, Susan ............. 32 MD .......................... 37 MD .......................... 13<br />
North DeKalb Health Palliative Pharmacy Pollock, Mark .............. 59 Randolph, Erich MD..... 60<br />
Center Solutions Inc ........... 70 Poly-Plex Pharmacy..... 75 Randolph, Erich MD..... 61<br />
Pharmacy ................ 71 Pancer, Stuart ............. 46 Pomerance, Alan ......... 21 Ranta, Annemarei........ 43<br />
Northside Alpharetta Pancer, Stuart ............. 50 Ponce Infectious Rao, Gopal MD ............ 24<br />
Pharmacy ................ 76 Parekh, Vishal MD ....... 16 Diseasse Center Rao, Heng ................... 56<br />
Northside Homecare Parikh, Asha MD.......... 15 Pharmac.................. 76 Raphael, Allen ............. 57<br />
Pharmacy ................ 72 Parikh, Asha MD.......... 16 Pope, Leslie................. 46 Raphael, Allen ............. 58<br />
Northside Hosp Phcy Parikh, Asha MD.......... 17 Pope, Leslie................. 50 Rashid, Qammer.......... 36<br />
at Medical Twr ........ 78 Parikh, Naresh............. 17 Porkert, Markus MD .... 25 Ratner, Joshua MD...... 39<br />
Northside Hospital Parris, Glenn................ 62 Powell, Otis MD........... 13 Rausher, David............ 35<br />
Phcy at Maridian Parrish, Charles........... 35 Prater, Stephen MD..... 24 Raval, Nirav MD .......... 24<br />
Mark ....................... 78 Patel,<br />
Price, Jennifer MD....... 58 Raviele, Kathleen MD .. 18<br />
Northside Hospital ....... 64 Dharmeshkumar...... 12 Price, Robert ............... 29 Raynor, B Denise MD .. 44<br />
Northside Patel,<br />
Price, Robert ............... 32 Raynor, B Denise MD .. 46<br />
Psychological Dharmeshkumar...... 14 Price, Robert ............... 41 Raynor, B Denise MD .. 48<br />
Services .................. 66 Patel, Dipak MD .......... 14 Pride Pharmacy ........... 76 Raynor, B Denise MD .. 51<br />
Nowlan, Adam MD ...... 61 Patel, Nipun MD .......... 15 Primrose Pharmacy ..... 84 Reaves, Vera MD......... 12<br />
Patel, Vijaykumar MD .. 37 Proctor, Eugene MD .... 25 Reddy, Kota MD .......... 24<br />
O<br />
Paterson, Tracy PA-C... 60 Providence Pharmacy .. 75 Reddy, Kota MD .......... 25<br />
O’Brien, Sean MD........ 29 Patten, Steven MD....... 15 Publix Pharmacy.......... 69 Reddy, Kota MD .......... 26<br />
O’Brien, Sean MD........ 32 Patterson, Veronica...... 14 Publix Pharmacy.......... 70 Reddy, Rohini MD........ 66<br />
O’Brien, Sean MD........ 34 Patterson, Veronica...... 17 Publix Pharmacy.......... 71 Reed, James MD......... 35<br />
Obialo, Chamberlain .... 43 Pattillo, Roland MD...... 48 Publix Pharmacy.......... 72 Regis, Micaline PA....... 24<br />
Oderinde, Adesoji Paul, Dara MD............. 20 Publix Pharmacy.......... 73 Reid, John................... 29<br />
MD .......................... 16 Paul, Ranjan ................ 17 Publix Pharmacy.......... 74 Renner, Courtney PA-<br />
Oduwole, Adefisayo Paulk, Elijah MD .......... 24 Publix Pharmacy.......... 75 C ............................. 62<br />
MD .......................... 24 Paulk, Tina NP............. 12 Publix Pharmacy.......... 76 Reynolds, Stacy MD .... 46<br />
Ofili, Elizabeth MD....... 26 Pavamani, E MD.......... 38 Publix Pharmacy.......... 77 Rheudasil, James<br />
Oh, Jung MD............... 21 Paylow Pharmacy ........ 73 Publix Pharmacy.......... 78 MD .......................... 63<br />
Ojo, Olofunso............... 15 Peachford Hospital ...... 64 Publix Pharmacy.......... 79 Richman, Craig MD ..... 55<br />
Okobah, Isioma MD..... 12 Peachford Hospital ...... 66 Publix Pharmacy.......... 80 Rim, Sharon MD.......... 32<br />
Okoli, Joel MD............. 37 Peachtree<br />
Publix Pharmacy.......... 81 Rim, Sharon MD.......... 34<br />
Okuwobi, Obafemi....... 12 Hematology and Publix Pharmacy.......... 82 Rite Aid Pharmacy<br />
Okuwobi, Obafemi....... 14 Oncology Consul ..... 74 Publix Pharmacy.......... 83 11676 ..................... 74<br />
Old Norcross Road Pennington, E. MD....... 27 Publix Pharmacy.......... 84 Rite Aid Pharmacy<br />
Pharmacy ................ 84 Pennington, E. ............. 27 Purdie, Jill MD............. 20 11677 ..................... 73<br />
Olson, David................ 43 Perry-Gilkes, Lisa Purdie, Jill MD............. 21 Rite Aid Pharmacy<br />
Olubuyide, Temitope MD .......................... 55 Purohit, Bhumiben 11678 ..................... 77<br />
MD .......................... 48 Petrey, Carolyn DO ...... 14 MD .......................... 14 Rite Aid Pharmacy<br />
Omole, Folashade Pham, Truc MD ........... 53 Pyramid Discount 11679 ..................... 77<br />
MD .......................... 13 Phan, Han MD ............. 44 Pharmacy ................ 73 Rite Aid Pharmacy<br />
Omotoso, Irene MD ..... 16 Pharmacy of<br />
11680 ..................... 73<br />
Q<br />
Optimal<br />
Southside Medical<br />
Rite Aid Pharmacy<br />
Psychological Center Inc ............... 73 Qidwai, Anila MBBS..... 13 11686 ..................... 81<br />
Services Inc ........... 66 Pharmalife Atlanta ....... 76 Quinn, Corinne MD...... 25 Rite Aid Pharmacy<br />
Orangio, Guy ............... 27 Pharmasouth ............... 75 Quinones, Michael....... 36 11687 ..................... 77<br />
Oropo, Sikirat .............. 41 Phillips, Christopher<br />
Rite Aid Pharmacy<br />
Osburne, Robert .......... 35 MD .......................... 16 R<br />
11689 ..................... 80<br />
Osinuga, Oladayo MD.. 15 Phillips, Kiwita MD ...... 48 Rite Aid Pharmacy<br />
Rabinowitz, Paul MD ... 22<br />
Osinuga, Oladayo MD.. 16 Phillips, Rogsbert......... 36 11690 ..................... 71<br />
Rafique, Shahid ........... 17<br />
Ostrow, Todd............... 32 Pierre, Felicia .............. 57<br />
Page 90 2012 Advantage by Peach State Health Plan HMO SNP
Index<br />
Rite Aid Pharmacy Rite Aid Pharmacy Sandy Springs Shepherd Apothecary .. 75<br />
11691 ..................... 70 11801 ..................... 71 Pharmacy ................ 78 Shepherd, Sharon<br />
Rite Aid Pharmacy Rite Aid Pharmacy Sarmiento, Ruth .......... 39 FNP-C...................... 17<br />
11693 ..................... 71 11802 ..................... 71 Sarmiento, Ruth .......... 40 Shinns Pharmacy......... 81<br />
Rite Aid Pharmacy Rite Aid Pharmacy Sarmiento, Ruth .......... 42 Sholas, Maurice........... 23<br />
11694 ..................... 70 11803 ..................... 77 Say, Phillip .................. 55 Sholas, Maurice........... 25<br />
Rite Aid Pharmacy Rite Aid Pharmacy Scales, Darrell MD ...... 54 Sholas, Maurice........... 26<br />
11695 ..................... 82 11804 ..................... 76 Schaffer, Kevin MD ..... 22 Sholas, Maurice........... 55<br />
Rite Aid Pharmacy Rite Aid Pharmacy Schancupp, Joel MD ... 58 Sholas, Maurice........... 56<br />
11699 ..................... 84 11811 ..................... 83 Scharyj, George MD .... 15 Shonkoff, David MD .... 26<br />
Rite Aid Pharmacy Rite Aid Pharmacy Scharyj, George MD .... 17 Shuler, Sara MD.......... 43<br />
11701 ..................... 80 11812 ..................... 82 Schechter, Ann............ 29 Siegel, Donald ............. 36<br />
Rite Aid Pharmacy Rivellese, Mark............ 51 Schechter, Ann............ 32 Siegel, Garry MD ......... 48<br />
11703 ..................... 81 Rivellese, Mark............ 52 Schertzer, Marion........ 27 Silberstein, Debra........ 50<br />
Rite Aid Pharmacy Rivellese, Mark............ 53 Schlatterer, Daniel Silk, Howard MD ......... 22<br />
11704 ..................... 80 Robert E. Springer III, MD .......................... 54 Silverman, Stuart MD .. 52<br />
Rite Aid Pharmacy Md, PC .................... 71 Schlefman, Barbara Simmons, Lorenza<br />
11706 ..................... 83 Roberts, James MD..... 46 DPM ........................ 57 MD .......................... 20<br />
Rite Aid Pharmacy Robinowitz, Michael Schneider, Julie........... 46 Simmons, Lorenza<br />
11720 ..................... 84 MD .......................... 48 Schneider, Julie........... 50 MD .......................... 48<br />
Rite Aid Pharmacy Romm, Philip MD ........ 24 Schub, Howard MD ..... 43 Simon, Roger MD ........ 44<br />
11721 ..................... 77 Romm, Philip MD ........ 26 Schwartz, Terry ........... 15 Simon, Timothy ........... 27<br />
Rite Aid Pharmacy Rose, Kelli ................... 63 Schwartz, Terry ........... 17 Simpson, Lijo MD ........ 39<br />
11722 ..................... 78 Rose, Myra MD ........... 16 Schwartz, Terry ........... 29 Simpson, Nicole .......... 32<br />
Rite Aid Pharmacy Rose, William .............. 63 Schwartz, Terry ........... 32 Singh, Inder................. 12<br />
11723 ..................... 75 Rosenthal, Robin PhD.. 67 Schwartzberg, Daniel .. 32 Singh, Inder................. 14<br />
Rite Aid Pharmacy Ross, Rhonda MD........ 12 Schwartzberg, Daniel .. 34 Singh, Narendra MD.... 23<br />
11724 ..................... 81 Ross, Rhonda MD........ 14 Schwartzberg, Daniel .. 41 Singh, Narendra MD.... 25<br />
Rite Aid Pharmacy Ross, Shalandra .......... 46 Scineaux, Tressa MD... 20 Singh, Narendra MD.... 26<br />
11726 ..................... 71 Rosser Jr., James Scott, Albert ................ 46 Singh, Rajender MD .... 17<br />
Rite Aid Pharmacy MD .......................... 37 Scott, Andre ................ 36 Singh, Varinder MD ..... 12<br />
11729 ..................... 82 Roth, Jeffrey................ 55 Seely, Melissa ............. 29 Singh, Varinder MD ..... 14<br />
Rite Aid Pharmacy Roy, Deanna MD ......... 14 Seely, Melissa ............. 32 Singhal, Sunit MD ....... 18<br />
11730 ..................... 81 Royal Style Segall, Nathan MD ...... 22 Sklare, Kelly ................ 50<br />
Rite Aid Pharmacy Pharmacy ................ 70 Seibert, Andrew........... 36 Sklare, Kelly ................ 51<br />
11731 ..................... 73 Rust, George ............... 13 Seniormed................... 74 Smith, Dominique........ 18<br />
Rite Aid Pharmacy<br />
11788 ..................... 75 S<br />
Seok, Woun DO ........... 14<br />
Sermons, Alvin MD...... 48<br />
Smith, Dominique........ 38<br />
Smith, Gary MD........... 48<br />
Rite Aid Pharmacy Safra, Mark ................. 52 Servera, Vigelo MD...... 17 Smith, Gregory MD...... 20<br />
11789 ..................... 74 Saint Louis, Hedwige Seward, Clifford........... 52 Smith, Nailah DC......... 26<br />
Rite Aid Pharmacy MD .......................... 48 Shah, Anand MD ......... 53 Smith, Sheila DO ......... 15<br />
11790 ..................... 79 Saint Louis, Hedwige... 48 Shah, Kirti MD............. 43 Snead, Laurie .............. 51<br />
Rite Aid Pharmacy Saint Louis, Hedwige... 50 Shah, Mahendra MD ... 66 Snells Pharmacy.......... 81<br />
11792 ..................... 70 Saligheh, Ali ................ 59 Shah, Suresh............... 17 Snyder, Averel MD ...... 62<br />
Rite Aid Pharmacy Saltzman, Steven MD.. 48 Shaheed, Naim............ 57 Snyder, David.............. 59<br />
11793 ..................... 75 Sams Pharmacy .......... 69 Shambaugh, George.... 35 Snyder, David.............. 60<br />
Rite Aid Pharmacy Sams Pharmacy .......... 70 Share, Jane................. 32 Social Empowerment<br />
11794 ..................... 74 Sams Pharmacy .......... 73 Sharma, Atul ............... 51 Center ..................... 66<br />
Rite Aid Pharmacy Sams Pharmacy .......... 80 Sharma, Atul ............... 52 Solomon, Eric .............. 55<br />
11796 ..................... 73 Sams Pharmacy .......... 82 Sharma, Atul ............... 53 Sonenshine, Marc<br />
Rite Aid Pharmacy Samuels, Angella Sharma, Chandi MD .... 17 MD .......................... 36<br />
11797 ..................... 77 CNP......................... 14 Sharma, Niraj MD........ 26 Song, David................. 23<br />
Rite Aid Pharmacy Sanders, Lawrence Sharma, Rita ............... 38 Song, Hanjoon MD ...... 37<br />
11798 ..................... 72 MD .......................... 16 Sharma, Sangita.......... 14 Southern Family<br />
Rite Aid Pharmacy Sandler, Manfred MD .. 26 Sheerin, Kathleen Market..................... 83<br />
11799 ..................... 71 MD .......................... 22<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 91
Index<br />
Southern Regional Stoltz, Robert............... 52 Terrelonge, Calvin Twiddy, Kenneth.......... 18<br />
Medical Center........ 64 Stoltz, Robert............... 53 MD .......................... 15 Tyber, Andy ................. 33<br />
Souza, Renato ............. 37 Stonecipher, Marcus ... 27 Tesfaye, Daniel............ 43 Tyber, Andy ................. 35<br />
Souza, Renato ............. 62 Stonecipher, Marcus ... 28 Tesfaye, Tassew .......... 12 Tyrrell, Robert.............. 33<br />
Sow, Charles ............... 13 Strayhorn, Gregory Tesfaye, Tassew .......... 13 Tyrrell, Robert.............. 35<br />
Soyoola, Emmanuel<br />
MD .......................... 21<br />
MD .......................... 13<br />
Stringer, Harold MD..... 17<br />
Tesfaye, Tassew .......... 14<br />
The Medicine U<br />
Spanier, Jacob MD...... 20 Strothers, Harry MD .... 13 Shoppe.................... 71 Uchegbu, Chukwudi<br />
Sparlin, Samuel DC ..... 26 Stubbs, Michael........... 62 The Pharmacy at MD .......................... 17<br />
Spaulding, Susan ........ 55 Stulting, Robert MD..... 53 Emory...................... 69 Udoff, Eric MD............. 33<br />
Spectrum Healthcare Subbannan, Karthi The Pharmacy Center.. 69 Udoff, Eric MD............. 35<br />
Solutions LLC .......... 82 MD .......................... 42 Thomas Burse, Ughwanogho, Ovie<br />
Speed, April MD .......... 36 Suburban Janella .................... 38 MD .......................... 40<br />
Spencer, Kimberly Hematology Thomas Burse, Ulett, Dane DO ............ 58<br />
MD .......................... 32 Oncology Assoc....... 80 Janella .................... 46 Ulett, Dane DO ............ 59<br />
Spencer, Leigh ............ 13 Suburban Thomas Burse, Umpierrez, Monica ...... 33<br />
Spiegl, Paul ................. 54 Hematology Janella .................... 49 Una Pharmacy<br />
Spiro, Rhonda.............. 38 Oncology Assoc....... 84 Thomas, Anastasia ...... 57 Corporation ............. 69<br />
Spitlzer, Susan ............ 27 Suddala, Satya MD...... 18 Thomas, Anastasia ...... 58 United Pharmacy<br />
Spitlzer, Susan ............ 28 Sugarloaf Pharmacy .... 83 Thomas, Sherine MD... 42 Services Christian<br />
Srinivasan, Suh, David................... 23 Thomas-Cloud, City.......................... 79<br />
Muthayyah .............. 23 Sullivan Psychiatric Rosemary................ 15 United Pharmacy<br />
Srinivasiah, Jayanthi ... 39 Services .................. 66 Thrower, Ben............... 44 Services of Atlanta<br />
Srinivasiah, Jayanthi ... 40 Summit Ridge Timani Charkawi, Inc........................... 80<br />
Srinivasiah, Jayanthi ... 41 Hospital................... 64 Shereen MD ............ 28 Unterman, Marc MD.... 25<br />
Srinivasiah, Jayanthi ... 42 Summit Ridge Tippins, Russell MD..... 33 Unterman, Marc MD.... 26<br />
Srivastava, Shikha Hospital................... 66 Tippins, Russell MD..... 34<br />
MD .......................... 37 Surgimed Suppliers ..... 73 Tirado, Lissette DPM ... 59 V<br />
St Josephs Sutton, Madeline MD... 46 Toca, Forrest MD......... 25<br />
Apothecary.............. 78 Sveum, Jonne CNM..... 51 Todd, Tobi MD ............. 58 Val, Franckel MD ......... 66<br />
St Julian, Tracey MD ... 20 Syed, Riaz MD............. 18 Todd, Tobi MD ............. 59 Vanderveldt,<br />
Stephanie................ 53<br />
Stahlman, Jon ............. 22 T<br />
Tomeh, Bassam MD .... 12 Vasandani, Geetanjali<br />
Stallmann, Jay............. 51<br />
Total Health Medical MD .......................... 17<br />
Tacoronti, Rudolph....... 63<br />
Stallmann, Jay............. 52 Center ..................... 70 Vassilev, Tzvetan MD .. 41<br />
Tagoe, Albert MD......... 63<br />
Stallmann, Jay............. 53<br />
Tracys Medicine Vassiliades, Venetia<br />
Tamim, Hiba ................ 39<br />
Stapleton, Sidney ........ 36 Center ..................... 70 MD .......................... 33<br />
Tandy, Diane CNM....... 48<br />
Steele, J...................... 33<br />
Tracys Medicine Vassiliades, Venetia<br />
Tanghal, Liza ............... 55<br />
Steinberg, Scott........... 36 Center ..................... 71 MD .......................... 35<br />
Tanner, David MD........ 22<br />
Steinberg, Scott........... 38 Tran, Steve .................. 15 Vemuri, Sreekanth....... 33<br />
Target Pharmacy ......... 69<br />
Stephan, Karen............ 23 Tran, Steve .................. 17 Vemuri, Sreekanth....... 35<br />
Target Pharmacy ......... 70<br />
Stephan, Karen............ 25 Trankina, Jon MD ........ 36 Venkatesh, Kota........... 27<br />
Target Pharmacy ......... 71<br />
Stephens, Augustus Trinh, Thai ................... 33 Videlefsky, Searle<br />
Target Pharmacy ......... 72<br />
MD .......................... 52 Trinity Pharmacy.......... 76 MD .......................... 26<br />
Target Pharmacy ......... 73<br />
Stephens, Augustus Tritt, Ramie MD ........... 55 Vilardo, John DC.......... 26<br />
Target Pharmacy ......... 74<br />
MD .......................... 53 Trivedi, Abhay.............. 23 Village Podiatry............ 82<br />
Target Pharmacy ......... 75<br />
Stephens, Latoya MD .. 18 Trivedi, Abhay.............. 25 Vinokur, Lisa MD......... 20<br />
Target Pharmacy ......... 76<br />
Stepnicka, Jill DPM ..... 58 Trivedi, Abhay.............. 26 Vivek, Uthan ................ 37<br />
Target Pharmacy ......... 77<br />
Stern, Mark ................. 35 Tucker, G..................... 20 Vivek, Uthan ................ 63<br />
Target Pharmacy ......... 78<br />
Stewart, Fermin MD .... 55 Tucker, G..................... 49 VN Pharmacy............... 83<br />
Target Pharmacy ......... 80<br />
Stewart, Lynette MD.... 46 Tucker, George MD...... 18 VN Pharmacy #2.......... 84<br />
Target Pharmacy ......... 81<br />
Stewart, Lynette MD.... 51 Tucker, George MD...... 20 Vova, Joshua............... 56<br />
Target Pharmacy ......... 82<br />
Stieber, Andrei............. 29 Target Pharmacy ......... 83 Tucker, George MD...... 46<br />
W<br />
Stieber, Andrei............. 36 Taubin, Rhonda ........... 55 Tucker, George MD...... 49<br />
Stiles, Richard ............. 33 Tenhoor, Terri .............. 59 Turknett, Joshua.......... 43 Wade, Thomas ............ 17<br />
Stoltz, Robert............... 51 Tenhoor, Terri .............. 60 Tuxedo Pharmacy ........ 74<br />
Page 92<br />
2012 Advantage by Peach State Health Plan HMO SNP
Index<br />
Wai Kiu Famcare<br />
Pharmacy ................ 72<br />
Walgreens #6699 ........ 80<br />
Walgreens #6875 ........ 73<br />
Wetter, Amy MD.......... 51<br />
Whaley, William........... 40<br />
Z<br />
Wal-Mart Pharmacy..... 69 Walgreens #6999 ........ 74 Whitehead, Eddie ........ 15 Zahner, Lynn MD......... 51<br />
Wal-Mart Pharmacy..... 70 Walgreens #7001 ........ 83 Whitmore, Simone Zimmerman, David<br />
Wal-Mart Pharmacy..... 71 Walgreens #7167 ........ 72 MD .......................... 21 MD .......................... 25<br />
Wal-Mart Pharmacy..... 72 Walgreens #7394 ........ 77 Whittaker, Winsome .... 15 Zimmermann, Julie ..... 39<br />
Wal-Mart Pharmacy..... 73 Walgreens #7395 ........ 79 Whittaker, Winsome .... 17 Zimmermann, Julie ..... 49<br />
Wal-Mart Pharmacy..... 74 Walgreens #7478 ........ 70 Wildstein, Albert .......... 63 Zora, John MD ............ 22<br />
Wal-Mart Pharmacy..... 75 Walgreens #7502 ........ 80 Wilkinson, Craig MD.... 61 Zweig, Julie................. 55<br />
Wal-Mart Pharmacy..... 77 Walgreens #7546 ........ 81 Williams III, Wilfred<br />
Wal-Mart Pharmacy..... 78 Walgreens #7608 ........ 72 MD .......................... 61<br />
Wal-Mart Pharmacy..... 79 Walgreens #7741 ........ 69 Williams, Andre ........... 18<br />
Wal-Mart Pharmacy..... 80 Walgreens #7958 ........ 81 Williams, D’nyce MD ... 20<br />
Wal-Mart Pharmacy..... 81 Walgreens #7959 ........ 80 Williams, Eugene MD .. 12<br />
Wal-Mart Pharmacy..... 82 Walgreens #7960 ........ 80 Williams, Eugene MD .. 14<br />
Wal-Mart Pharmacy..... 83 Walgreens #7995 ........ 71 Williams, Joseph ......... 57<br />
Wal-Mart Pharmacy..... 84 Walgreens #9303 ........ 76 Williams, Michael ........ 37<br />
Walgreens ................... 70 Walgreens #9451 ........ 78 Williams, Robert MD.... 38<br />
Walgreens ................... 78 Walgreens #9494 ........ 83 Williams, Robert MD.... 39<br />
Walgreens ................... 84 Walgreens #9620 ........ 77 Williams, Tina MD ....... 15<br />
Walgreens #10248 ...... 82 Walgreens #9621 ........ 70 Williams, Tosha ........... 60<br />
Walgreens #10265 ...... 77 Walgreens #9630 ........ 77 Williams, Tosha ........... 61<br />
Walgreens #10422 ...... 76 Wamer, Angela............ 44 Williamson, Mitchell<br />
Walgreens #10457 ...... 72 Wang, Zhengxiang....... 52 MD .......................... 44<br />
Walgreens #10902 ...... 83 Ward, Garrett MD ........ 63 Wills, Noah .................. 15<br />
Walgreens #11102 ...... 79 Washington Road Wills, Noah .................. 17<br />
Walgreens #11488 ...... 75 Pharmacy ................ 76 Wilson, Carmen ........... 53<br />
Walgreens #11993 ...... 73 Watkins, Clyde............. 15 Wilson, David MD........ 27<br />
Walgreens #12147 ...... 84 Watson, Nardia NP ...... 17 Wilson, Kenneth MD.... 36<br />
Walgreens #12262 ...... 70 Wayfield Pharmacy...... 76 Wilson, Kenneth MD.... 37<br />
Walgreens #12604 ...... 76 Weakland, Laura MD ... 42 Winn, Stephanie MD.... 66<br />
Walgreens #13641 ...... 76 Weaver, Carolyn .......... 33 Winston, Alan .............. 37<br />
Walgreens #2359 ........ 72 Weaver, Carolyn .......... 35 Winston, Alan .............. 62<br />
Walgreens #5336 ........ 72 Weeks, Christina.......... 53 Wobeck, Linda MD ...... 61<br />
Walgreens #5446 ........ 82 Weens, Joan MD ......... 39 Woodall, Lesli .............. 56<br />
Walgreens #5580 ........ 69 Weinberg, Judd DC ..... 26 Woodhouse, Sheila<br />
Walgreens #5605 ........ 79 Weinstein, Lawrence MD .......................... 26<br />
Walgreens #5759 ........ 72 MD .......................... 49 Woolfson, Jonathan<br />
Walgreens #5760 ........ 76 Weissman, Joseph ...... 43 MD .......................... 53<br />
Walgreens #5896 ........ 80 Welch, Lisa.................. 15 Work, Frederick MD..... 57<br />
Walgreens #5898 ........ 78 Wender & Roberts - Wright, Faith LCSW ..... 67<br />
Walgreens #5899 ........ 80 Crabapple................ 73 Wu, Chuansheng ......... 59<br />
Walgreens #5903 ........ 77 Wender & Roberts - Wurapa, Anson............ 40<br />
Walgreens #5989 ........ 81<br />
Walgreens #5990 ........ 81<br />
LTC.......................... 73<br />
Wender & Roberts Y<br />
Walgreens #6032 ........ 78 Drugs - WPF ........... 74 Yan, Linda ................... 23<br />
Walgreens #6088 ........ 81 Wender and Roberts.... 74 Yarde, William.............. 44<br />
Walgreens #6138 ........ 69 Wender and Roberts Yoo Pharmacy.............. 80<br />
Walgreens #6185 ........ 81 Assisted Living ........ 73 You, Alice MD.............. 15<br />
Walgreens #6202 ........ 72 West End Pharmacy .... 79 You, Alice MD.............. 18<br />
Walgreens #6204 ........ 79 Westend Discount Your Pharmacy<br />
Walgreens #6205 ........ 70 Pharmacy ................ 78 Solution................... 75<br />
Walgreens #6207 ........ 84 Westney, Gloria ........... 60 Yowler, Deena CNM..... 49<br />
Walgreens #6276 ........ 79 Weston-Hill, Zada Yowler, Deena CNM..... 51<br />
Walgreens #6481 ........ 71 MD .......................... 12<br />
Walgreens #6638 ........ 81 Wetter, Amy MD.......... 49<br />
2012 Advantage by Peach State Health Plan HMO SNP Page 93
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