Healthcare Provider Details

I. General information

NPI: 1679935027
Provider Name (Legal Business Name): JUSTIN ALEXANDER BILLINGS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2016
Last Update Date: 02/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 HEMLOCK ST MSC 69
MACON GA
31201-2102
US

IV. Provider business mailing address

777 HEMLOCK ST MSC 69
MACON GA
31201-2102
US

V. Phone/Fax

Practice location:
  • Phone: 478-633-1700
  • Fax: 478-633-7032
Mailing address:
  • Phone: 478-633-1700
  • Fax: 478-633-7032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number008442
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: