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General NPI Number Information
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NPI Number | 1801822515
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Entity Type | Organization
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Legal Business Name | THE NEXUS MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 777 HEMLOCK ST
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City | MACON
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State | GA
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Zip | 31201-2102
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Country | US
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Telephone | 478-742-8297
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Fax | 478-742-9670
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Provider Business Mailing Address
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Address Line | 777 HEMLOCK ST MSC 159
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City | MACON
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State | GA
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Zip | 31201-2102
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Country | US
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Telephone | 478-742-8297
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Fax | 478-742-9670
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | GENIE WARD
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Credential |
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Telephone | 478-633-2147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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