Individual ProviderRobert C. WirtFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address597 S Enota Dr NE, Gainesville, GA 30501-2545(770) 219-7777(770) 219-8420PECOS EnrollmentBased on the most recent information from CMS, provider Robert C. Wirt does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1871586115Provider TypeIndividualFull NameWirt, Robert C.CredentialD.O.GenderMaleSole ProprietorNoEnumeration Date8/23/2005Last Updated2/19/2010Contact InformationPractice LocationPractice Address597 S Enota Dr NE, Gainesville, GA 30501-2545Phone(770) 219-7777Fax(770) 219-7778Mailing LocationMailing Address601 S Enota Dr NE, Suite Q, Gainesville, GA 30501-2400Phone(770) 219-8420Fax(770) 219-8440Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense026686GeorgiaProvider IdentifiersIDDescriptionIssuerID00365538CDescriptionMedicaidIssuerUnlistedGeorgia