Healthcare Provider Details

I. General information

NPI: 1376159590
Provider Name (Legal Business Name): SOUND PHYSICIANS INTENSIVISTS OF GEORGIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2020
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CHARTER BLVD
MACON GA
31210-4831
US

IV. Provider business mailing address

120 BRENTWOOD COMMONS WAY STE 510
BRENTWOOD TN
37027-2028
US

V. Phone/Fax

Practice location:
  • Phone: 478-757-8200
  • Fax:
Mailing address:
  • Phone: 253-682-6040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA FALL
Title or Position: MANAGER
Credential:
Phone: 253-682-6040