MEDICARE: HOUSTON COUNTY HEALTH DEPARTMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	2083P0901X	Public Health & General Preventive Medicine Physician
2	261QP0905X	State or Local Public Health Clinic/Center
3	261QP0905X	State or Local Public Health Clinic/Center	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689631715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON COUNTY HEALTH DEPARTMENT

Provider Business Mailing Address
First Line	:	180 EMERY HWY
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31217-3656
Country	:	US
Telephone Number	:	478-464-0612
Fax Number	:	478-464-0002

Provider Business Practice Location Address
First Line	:	3920 ARKWRIGHT RD STE 415
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31210-1731
Country	:	US
Telephone Number	:	478-464-0612
Fax Number	:	478-464-0002

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	DANIELLE MCNAIR
Credential	:
Telephone Number	:	478-751-6303

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	11/05/2024

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Directions to “HOUSTON COUNTY HEALTH DEPARTMENT ” Practice Location

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