| Burton Medical Group LLC | |
|
210 Mercer Jct Macon GA 31210-4016 | |
| (478) 471-8593 | |
| (478) 471-8599 |
| Full Name | Burton Medical Group LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 210 Mercer Jct, Macon, Georgia |
| Authorized Official Name and Position | Lisa Sanford (OFFICE MANAGER) |
| Authorized Official Contact | 4784718593 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Burton Medical Group LLC 210 Mercer Jct Macon GA 31210-4016 Ph: (478) 471-8593 | Burton Medical Group LLC 210 Mercer Jct Macon GA 31210-4016 Ph: (478) 471-8593 |
| NPI Number | 1508169426 |
|---|---|
| Provider Enumeration Date | 12/15/2010 |
| Last Update Date | 12/15/2010 |
| Medicare PECOS PAC ID | 4880882067 |
|---|---|
| Medicare Enrollment ID | O20110104000004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508169426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 038434 (Georgia) | Primary |
| 207Q00000X | Family Medicine | 061948 (Georgia) | Secondary |
| 207Q00000X | Family Medicine | 002499 (Georgia) | Secondary |
| Provider Name | Frederick a Burton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912947326 PECOS PAC ID: 6002854874 Enrollment ID: I20050421000856 |
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