Individual
YAOWARAT WAJANAPONSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
560 1ST ST, MACON, GA 31201-2824
(478) 744-9603
(478) 744-9917
Mailing address
970 HUNTCLIFFE CT, MACON, GA 31210-7553
(808) 352-8373
(478) 474-4731
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
061369
GA
390200000X
Student in an Organized Health Care Education/Training Program
MDR4794
HI
Other
Enumeration date
05/26/2007
Last updated
02/09/2009
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