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Individual

CASEY UNDERHILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
380 HOSPITAL DR, BLDG A SUITE 430, MACON, GA 31217
(478) 751-0181
Mailing address
380 HOSPITAL DR, BLDG A SUITE 430, MACON, GA 31217
(478) 751-0181

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
01078831A
IN
207P00000X
Emergency Medicine Physician
Primary
01078831A
IN
208D00000X
General Practice Physician
01078831A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01078821A
STATE LICENSE
IN
Enumeration date
03/22/2016
Last updated
06/03/2021
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