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Organization
MACON VASCULAR CARE, LLC
Active
Organization
MACON VASCULAR CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA A MCNAMARA (EXECUTIVE VICE PRESIDENT)
(239) 597-2010
Entity
Organization
Contact information
Practice address
889 2ND ST, MACON, GA 31201-6862
(478) 254-9363
Mailing address
9140 CORSEA DEL FONTANA WAY, NAPLES, FL 34109-4397
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
08/22/2013
Last updated
08/22/2013
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