Individual
JUSTIN MCIVOR LAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 COLEMAN AVE, MACON, GA 31207-0001
(478) 301-2700
Mailing address
1400 COLEMAN AVE, MACON, GA 31207-0001
(478) 301-2700
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
72978
TN
207Q00000X
Family Medicine Physician
076754
GA
Other
Enumeration date
08/16/2012
Last updated
04/25/2025
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