Organization
MAC - MACON ROAD LLC
Active
Parent organization
COLUMBUS CLINIC, P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLUMBUS CLINIC, P.C.
Authorized official
ROBERT O'NEIL SNODDY MD (MEDICAL DIRECTOR)
(706) 243-3051
Entity
Organization
Contact information
Practice address
3465 MACON RD STE D, COLUMBUS, GA 31907-2582
(706) 243-3051
Mailing address
PO BOX 84052, COLUMBUS, GA 31908-4052
(706) 243-0626
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
934157678A
—
GA
Enumeration date
02/01/2008
Last updated
10/07/2008
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