Organization
RADIOLOGY ASSOCIATES OF MACON PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK E GROSSNICKLE M.D. (PRESIDENT)
(478) 743-1458
Entity
Organization
Contact information
Practice address
770 PINE ST STE 290, ATTN: RADIOLOGY DEPARTMENT, MACON, GA 31201-7516
(478) 743-1458
(478) 755-1332
Mailing address
770 PINE ST STE 290, ATTN: RADIOLOGY DEPARTMENT, MACON, GA 31201-7516
(478) 743-1458
(478) 755-1332
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
10/26/2005
Last updated
11/06/2012
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