Healthcare Provider Details

I. General information

NPI: 1427344753
Provider Name (Legal Business Name): FIONA CLAIRE KEHOE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 06/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 HEMLOCK ST
MACON GA
31201-2102
US

IV. Provider business mailing address

777 HEMLOCK ST
MACON GA
31201-2102
US

V. Phone/Fax

Practice location:
  • Phone: 478-633-5500
  • Fax: 478-784-5496
Mailing address:
  • Phone: 478-633-5500
  • Fax: 478-784-5496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number005096
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: