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NPI Code Detail

MEDICARE: GGD, INC.

MEDICARE: GGD, INC.
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianGA

General Provider Information

NPI Number : 1831119304
Entity Type Code : Organization
Provider Name (Legal Business Name) : GGD, INC.
Provider Business Mailing Address
First Line : PO BOX 5048
Second Line :
City : MACON
State : GA
Zip : 31208-5048
Country : US
Telephone Number : 478-825-3317
Fax Number : 478-825-5499
Provider Business Practice Location Address
First Line : 201 AVERA DR
Second Line :
City : FORT VALLEY
State : GA
Zip : 31030-5008
Country : US
Telephone Number : 478-825-3317
Fax Number : 478-825-5499
Authorized Official
Title or Position : OWNER
Name : MICHAEL WAYNE EARLY SR.
Credential : M.D.
Telephone Number : 478-825-3317
Provider Enumeration Date : 07/20/2006
Last Update Date : 02/01/2011

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Directions to “GGD, INC. ” Practice Location

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