Organization
MCC INTERNAL MEDICINE 2, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLEY DEPP (PAYER RELATIONS LIAISON)
(770) 579-2626
Entity
Organization
Contact information
Practice address
6501 PEAKE RD, SUITE 100, MACON, GA 31210-8042
(478) 273-2662
(478) 246-0637
Mailing address
PO BOX 468329, ATLANTA, GA 31146-8329
(770) 579-2626
(866) 499-4593
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
66228
GA
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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