Organization
ALLERGY & ASTHMA CLINIC OF MACON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID T PLAXICO M.D (OWNER)
(478) 743-9376
Entity
Organization
Contact information
Practice address
2076 INGLESIDE AVE, MACON, GA 31204-2028
(478) 743-9376
(478) 743-4670
Mailing address
2076 INGLESIDE AVE, MACON, GA 31204-2028
(478) 743-9376
(478) 743-4670
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
022621
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY NUMBER
GA
05
—
000270905A
—
GA
01
—
010001168
RAILROAD MEDICARE
GA
01
—
D30479
UPIN
GA
Enumeration date
11/21/2007
Last updated
05/21/2020
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