| Mac - Macon Road Llc | |
|
3465 Macon Rd Ste D Columbus GA 31907-2582 | |
| (706) 243-3051 | |
| Not Available |
| Full Name | Mac - Macon Road Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 3465 Macon Rd Ste D, Columbus, Georgia |
| Authorized Official Name and Position | Robert O'neil Snoddy (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7062433051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mac - Macon Road Llc Po Box 84052 Columbus GA 31908-4052 Ph: (706) 243-0626 | Mac - Macon Road Llc 3465 Macon Rd Ste D Columbus GA 31907-2582 Ph: (706) 243-3051 |
| NPI Number | 1053599043 |
|---|---|
| Provider Enumeration Date | 02/01/2008 |
| Last Update Date | 10/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053599043 | NPI | - | NPPES |
| 934157678A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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