Organization
PALMYRA SURGICAL, LLC
Active
Other names
Palmyra Surgical, LLC (Macon)
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VITO JOHN BAGNATO MD (OWNER/PRESIDENT)
(229) 432-8484
Entity
Organization
Contact information
Practice address
420 CHARTER BLVD, SUITE 103, MACON, GA 31210-4854
(229) 432-8484
(229) 432-8487
Mailing address
810 13TH AVE STE 108, ALBANY, GA 31701-1333
(229) 432-8484
(229) 432-8487
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
45711
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09936
MISSISSIPPI LICENSE NUMBER
MS
Enumeration date
12/28/2011
Last updated
12/28/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us