Organization
POPLAR PHYSICIANS, LLC
Active
Organization
POPLAR PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHNNY D SHEPPARD BS (ADMINISTRATOR)
(478) 746-1218
Entity
Organization
Contact information
Practice address
446 POPLAR ST, SUITE B, MACON, GA 31201-3336
(478) 746-1218
(478) 750-9594
Mailing address
446 POPLAR ST, SUITE B, MACON, GA 31201-3336
(478) 746-1218
(478) 750-9594
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE0448
RAILROAD MEDICARE
GA
Enumeration date
12/28/2006
Last updated
09/02/2008
Update your record
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