Healthcare Provider Details
I. General information
NPI: 1629493481
Provider Name (Legal Business Name): DEVIN M POSTON PA-A
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/03/2014
Last Update Date: 03/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
380 HOSPITAL DRIVE SUITE 410
MACON GA
31217-8014
US
IV. Provider business mailing address
PO BOX 2564
MACON GA
31203-2565
US
V. Phone/Fax
- Phone: 478-746-5644
- Fax: 478-745-4849
- Phone: 478-746-5644
- Fax: 478-745-4849
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367H00000X |
| Taxonomy | Anesthesiologist Assistant |
| License Number | |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: