Individual
ALICE ROSE HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1550 COLLEGE ST, SUITE A, MACON, GA 31207-0001
(478) 301-4111
(478) 301-5812
Mailing address
PO BOX 4947, MACON, GA 31208-4947
(478) 301-2362
(478) 301-2272
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
043065
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000807364C
—
GA
01
—
080188724
RAILROAD MEDICARE
GA
Enumeration date
09/21/2006
Last updated
07/18/2014
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