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General NPI Number Information
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NPI Number | 1164574885
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Entity Type | Organization
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Legal Business Name | MACON COUNTY MEDICAL CENTER, INC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 80 WEST MAIN STREET STE B
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City | BUTLER
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State | GA
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Zip | 31006-5156
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Country | US
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Telephone | 478-862-3879
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Fax |
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Provider Business Mailing Address
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Address Line | 80 WEST MAIN ST. STE B
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City | BUTLER
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State | GA
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Zip | 31006-5156
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Country | US
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Telephone | 478-862-3879
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. LAURIE HAIR
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Credential | CFO
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Telephone | 478-472-3244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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