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General NPI Number Information
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NPI Number | 1669521902
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Entity Type | Organization
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Legal Business Name | CENTRAL GEORGIA PULMONARY ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 840 PINE STREET . SUITE 780
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City | MACON
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State | GA
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Zip | 31201
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Country | US
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Telephone | 478-744-2445
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Fax | 478-744-0906
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Provider Business Mailing Address
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Address Line | 840 PINE STREET . SUITE 780
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City | MACON
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State | GA
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Zip | 31201
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Country | US
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Telephone | 478-744-2445
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Fax | 478-744-0906
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CLAY W SPENCE
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Credential |
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Telephone | 478-744-2445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number | 043061
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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