Organization
CARDIO THORACIC VASCULAR & PEDIATRIC SURGERY ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE WEEMS (OFFICE MANAGER)
(478) 742-7566
Entity
Organization
Contact information
Practice address
688 WALNUT ST, SUITE 200, MACON, GA 31201-2677
(478) 742-7566
(478) 743-2804
Mailing address
688 WALNUT ST, SUITE 200, MACON, GA 31201-2677
(478) 742-7566
(478) 743-2804
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
11/20/2006
Last updated
10/06/2011
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