Organization
GASTRO SOUTH ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL R JUDAH MD (MANAGING MEMBER)
(478) 508-8113
Entity
Organization
Contact information
Practice address
249 SHERATON BLVD, MACON, GA 31210-1359
(478) 508-8113
Mailing address
249 SHERATON BLVD, MACON, GA 31210-1359
(478) 508-8113
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
03/31/2022
Last updated
08/02/2023
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