Individual
AMY D KINGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
682 HEMLOCK ST, SUITE 490, MACON, GA 31201-8307
(478) 741-1208
(478) 741-1557
Mailing address
682 HEMLOCK ST, SUITE 490, MACON, GA 31201-8307
(478) 741-1208
(478) 741-1557
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
002870
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
936764307A
—
GA
Enumeration date
06/15/2006
Last updated
09/29/2011
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