Individual
DR. MARY KATHRYN MCMAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
163 E TOLLISON ST, BAXLEY, GA 31513-0120
(912) 367-9841
(912) 367-7203
Mailing address
PO BOX 2070, BAXLEY, GA 31515-2070
(912) 367-9841
(912) 367-7203
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
062860
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
752201798A
—
GA
05
—
G62860
—
SC
01
—
P00758575
MEDICARE RR
GA
Enumeration date
09/13/2007
Last updated
02/11/2020
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