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Bruce F Middendorf

Internal Medicine

Allopathic & Osteopathic Physicians

1500 Oglethorpe Ave Ste 200c, Athens, GA 30606-2165

PECOS Enrollment

This provider is enrolled in PECOS as BRUCE MIDDENDORF.

Based on the most recent information from CMS, provider Bruce F Middendorf is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 8:18 PM.

Profile Details

Provider ID
1073524393
Provider Type
Individual
Full Name
Middendorf, Bruce F
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
8/11/2006
Last Updated
10/25/2022

Contact Information

Practice Location

1500 Oglethorpe Ave Ste 200c, Athens, GA 30606-2165

(706) 389-3875

(706) 389-3876

Mailing Location

PO Box 48089, Athens, GA 30604-8089

(706) 389-3727

(706) 389-3951

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 51768 Georgia

Bruce F Middendorf

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Lucas, Robert Patrick

Murrow, Laurel Boykin

Ward, Lela Anne Laseter

Taylor, Brandon J

Smith, Lisa D

Zakaria, Tariq Wael

Hoy, Alexandria

Cook, Meghan B

Morel Ovalle, Alain Marcel

Baldwin, Erin A