# MALDONADO & MORENO, PC

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

## Provider details

- **NPI number:** 1699815340
- **Authorized official:** CATHY WASHINGTON (BILLING)
- **Authorized official phone:** (770) 775-4622

## Contact information

- **Practice address:** 375 MCDONOUGH RD, JACKSON, GA 30233-1509
- **Practice address phone:** (770) 775-4622
- **Mailing address:** 375 MCDONOUGH RD, JACKSON, GA 30233-1509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 022255 | GA | — |
| 207Q00000X | Family Medicine Physician | 046792 | GA | Yes |
| 225X00000X | Occupational Therapist | OT002221 | GA | — |

## Other

- **Enumeration date:** 02/08/2007
- **Last updated:** 04/10/2015