Individual
PATRICK SEAN KINSELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
764 PINE ST, MACON, GA 31201-2107
(478) 301-5824
Mailing address
764 PINE ST, MACON, GA 31201-2107
(478) 301-5824
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11262
GA
207RI0200X
Infectious Disease Physician
0101282110
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/19/2019
Last updated
10/23/2024
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