Organization
KETAMINE CENTERS OF CENTRAL GEORGIA LLC
Active
Other names
Ketamine Center of Central Georgia
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUDAH GREENBERG MD (DOCTOR OWNER)
(478) 201-9220
Entity
Organization
Contact information
Practice address
3312 NORTHSIDE DR STE D235, MACON, GA 31210-0426
(478) 201-9220
(478) 203-9322
Mailing address
6275 RIVOLI DR, MACON, GA 31210-1456
(478) 363-0016
(478) 203-9322
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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