Organization
CENTRAL GEORGIA GASTROENTEROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LESLIE DIXON (BILLING OFFICE MANAGER)
(478) 474-1769
Entity
Organization
Contact information
Practice address
791 POPLAR ST, MACON, GA 31201-2045
(478) 474-1769
Mailing address
791 POPLAR ST, MACON, GA 31201-2045
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
037564
GA
Other
Enumeration date
04/28/2011
Last updated
06/01/2011
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