Individual
MARCO A AYULO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
207 FAIRVIEW PARK DR, DUBLIN, GA 31021-2550
(478) 275-1111
(478) 488-3477
Mailing address
501 RIVERSIDE DR, WAYCROSS, GA 31501-5316
(912) 283-6152
(912) 283-5264
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036088
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00516612A
—
GA
05
—
00516612F
—
GA
Enumeration date
11/03/2005
Last updated
07/10/2023
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