# JACQUELYN MACEY PA-C LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336608942
- **Authorized official:** JACQUELYN DENISE MACEY PA-C (PHYSICAIAN ASSISTANT)
- **Authorized official phone:** (850) 582-1221

## Contact information

- **Practice address:** 2400 WISTERIA DR STE A, SNELLVILLE, GA 30078-2689
- **Practice address phone:** (770) 985-9330
- **Mailing address:** 1105 TOWN BLVD NE UNIT 2302, BROOKHAVEN, GA 30319-3662
- **Mailing address phone:** (850) 582-1221

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 03/14/2019
- **Last updated:** 03/14/2019