Registry details
Type
Individual
Primary specialty
Family Medicine, Geriatric Medicine
Enumerated
Feb 23, 2006
License(s)
034759 (GA), 034759 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3780 EISENHOWER PKWY | Macon, GA 31206-0800 | 478-633-5500 |
| MAILING | 3780 EISENHOWER PKWY | Macon, GA 31206-0800 | 478-633-5500 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.