# PEDIATRIX MEDICAL GROUP

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

## Provider details

- **NPI number:** 1467677476
- **Authorized official:** TERESA G WILDER RNCNNP (NURSE PRACTITIONER)
- **Authorized official phone:** (478) 765-4132

## Contact information

- **Practice address:** 777 HEMLOCK ST, BOX 119, MACON, GA 31207-0001
- **Practice address phone:** (478) 633-1626
- **Practice address fax:** (478) 765-4171
- **Mailing address:** 777 HEMLOCK ST, BOX 119, MACON, GA 31207-0001
- **Mailing address phone:** (478) 633-1626

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | R030659 | GA | Yes |

## Other

- **Enumeration date:** 04/16/2007
- **Last updated:** 08/22/2020