Organization
MACON WOMEN'S HEALTH CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELISHA LOVE KITCHEN MD (OWNER/PHYSICIAN)
(478) 742-5502
Entity
Organization
Contact information
Practice address
718 1ST ST, MACON, GA 31201-6840
(478) 742-5502
(478) 742-5505
Mailing address
718 1ST ST, MACON, GA 31201-6840
(478) 742-5502
(478) 742-5505
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
051343
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
560266765B
—
GA
Enumeration date
07/08/2015
Last updated
07/08/2015
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