| Internal Medicine of Macon LLC | |
|
770 Pine St Ste 210 Macon GA 31201-7512 | |
| (478) 746-0901 | |
| (478) 250-8395 |
| Full Name | Internal Medicine of Macon LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 770 Pine St Ste 210, Macon, Georgia |
| Authorized Official Name and Position | Daniel Ukpong (DO) |
| Authorized Official Contact | 4787460901 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine of Macon LLC 770 Pine St Ste 210 Macon GA 31201-7512 Ph: (478) 746-0901 | Internal Medicine of Macon LLC 770 Pine St Ste 210 Macon GA 31201-7512 Ph: (478) 746-0901 |
| NPI Number | 1437815826 |
|---|---|
| Provider Enumeration Date | 11/10/2021 |
| Last Update Date | 11/26/2024 |
| Certification Date | 11/26/2024 |
| Medicare PECOS PAC ID | 8224421615 |
|---|---|
| Medicare Enrollment ID | O20220208000211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437815826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Daniel E Ukpong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376805192 PECOS PAC ID: 2567683410 Enrollment ID: I20170908002926 |
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