Organization
COGENT HEALTHCARE OF MACON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA SIMONTON LAND (MANAGER)
(478) 475-1299
Entity
Organization
Contact information
Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(478) 633-7550
(478) 633-3235
Mailing address
PO BOX 26040, MACON, GA 31221-6040
(478) 475-1299
(478) 405-7928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260348606A
—
GA
Enumeration date
05/12/2006
Last updated
12/19/2016
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