Organization
GRACE FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER B REEVES MD (PRESIDENT)
(478) 405-0280
Entity
Organization
Contact information
Practice address
440 CHARTER BLVD, SUITE 3303, MACON, GA 31210-4857
(478) 405-0280
(478) 405-0290
Mailing address
440 CHARTER BLVD, SUITE 3303, MACON, GA 31210-4857
(478) 405-0280
(478) 405-0290
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
049604
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000925955B
—
GA
01
—
998226
BCBS
GA
01
—
P00348683
RAILROAD MEDICARE
GA
Enumeration date
07/18/2013
Last updated
07/18/2013
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