Healthcare Provider Details

I. General information

NPI: 1417017989
Provider Name (Legal Business Name): AYSE F. GENC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 HEMLOCK ST
MACON GA
31201-2102
US

IV. Provider business mailing address

598 3RD ST
MACON GA
31201-3574
US

V. Phone/Fax

Practice location:
  • Phone: 478-633-6706
  • Fax: 478-633-5384
Mailing address:
  • Phone: 478-633-6706
  • Fax: 478-633-5384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number050882
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number61886
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number050882
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: