Organization
MACON OCCUPATIONAL MEDICINE
Active
Parent organization
MACON OCCUPATIONAL MEDICINE
Other names
Fort Valley State University Student Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
MACON OCCUPATIONAL MEDICINE
Authorized official
LEONARD BEVILL (PRESIDENT/CEO)
(478) 751-2900
Entity
Organization
Contact information
Practice address
1005 STATE UNIVERSITY DR, FORT VALLEY, GA 31030-4313
(478) 972-8900
Mailing address
124 3RD ST, MACON, GA 31201-3404
(478) 751-2925
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
—
—
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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