Individual
GREGORY S MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-AA
Contact information
Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(866) 507-5244
(855) 851-4405
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
003721
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100002067A
PEACHSTATE CMO - MCCG
GA
05
—
100002067A
—
GA
01
—
344356
WELLCARE CMO - MCCG
GA
Enumeration date
05/01/2007
Last updated
11/17/2014
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