Organization
BAINBRIDGE MEDICAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON MALLORY MCRAE M.D. (PHYSICIAN)
(229) 248-8580
Entity
Organization
Contact information
Practice address
1518 MILULI AVE, BAINBRIDGE, GA 39819-4866
(229) 248-8500
(229) 248-8600
Mailing address
1518 MILULI AVE, BAINBRIDGE, GA 39819-4866
(229) 248-8500
(229) 248-8600
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP6258
MEDICARE
GA
Enumeration date
11/28/2007
Last updated
10/25/2012
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