Organization
MEDICAL MANAGEMENT OF MACON, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STUART YACHNOWITZ (PRESIDENT)
(516) 371-4000
Entity
Organization
Contact information
Practice address
29612 KELLOGG AVE, MACON, MO 63552-3702
(660) 385-5797
Mailing address
29612 KELLOGG AVE, MACON, MO 63552-3702
(660) 385-5797
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031177
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30164
BC BS
MO
Enumeration date
07/12/2006
Last updated
08/22/2020
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