Organization
PREFERRED VASCULAR SERVICES MACON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
889 2ND ST, MACON, GA 31201-6862
(478) 254-9363
(478) 254-9362
Mailing address
9140 CORSEA DEL FONTANA WAY, NAPLES, FL 34109-4397
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
02/16/2018
Last updated
02/06/2026
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