Individual
DR. MICHAEL G MACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7700 E FLORENTINE RD, BLDG B, STE 203, PRESCOTT VALLEY, AZ 86314-2245
(928) 442-8740
(928) 442-8142
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(928) 759-5874
(928) 458-2039
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
53388
AZ
208600000X
Surgery Physician
D0030763
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126571700
—
MD
05
—
218939
—
AZ
Enumeration date
05/23/2005
Last updated
02/21/2017
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