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Organization
PREFERRED VASCULAR SERVICES MACON LLC
Active
Organization
PREFERRED VASCULAR SERVICES MACON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
889 2ND ST, MACON, GA 31201-6862
(478) 254-9363
(478) 254-9362
Mailing address
9140 CORSEA DEL FONTANA WAY, NAPLES, FL 34109-4397
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
02/16/2018
Last updated
02/06/2026
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