| Davey R. Deal, Jr., M.d., Llc | |
|
310 Hospital Dr Ste 305 Macon GA 31217-8030 | |
| (478) 338-9200 | |
| Not Available |
| Full Name | Davey R. Deal, Jr., M.d., Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 310 Hospital Dr Ste 305, Macon, Georgia |
| Authorized Official Name and Position | Davey Deal (OWNER) |
| Authorized Official Contact | 4783389200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Davey R. Deal, Jr., M.d., Llc 310 Hospital Dr Ste 305 Macon GA 31217-8030 Ph: (478) 338-9200 | Davey R. Deal, Jr., M.d., Llc 310 Hospital Dr Ste 305 Macon GA 31217-8030 Ph: (478) 338-9200 |
| NPI Number | 1114401486 |
|---|---|
| Provider Enumeration Date | 09/21/2018 |
| Last Update Date | 09/21/2018 |
| Medicare PECOS PAC ID | 2163766007 |
|---|---|
| Medicare Enrollment ID | O20181204003113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114401486 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Davey R Deal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1538131313 PECOS PAC ID: 3173429727 Enrollment ID: I20031212000311 |
| Provider Name | Angela Polk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083135271 PECOS PAC ID: 4981950490 Enrollment ID: I20180712002520 |
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