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General NPI Number Information
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NPI Number | 1942602941
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Entity Type | Organization
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Legal Business Name | YOUR DOCTOR'S AFTER HOURS, LLC
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Dates
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Enumeration Date | 09/22/2014
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Last Update Date | 09/22/2014
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Provider Practice Location Address
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Address Line | 610 3RD ST
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City | MACON
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State | GA
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Zip | 31201-3294
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Country | US
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Telephone | 478-254-5232
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Fax | 478-254-5232
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Provider Business Mailing Address
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Address Line | 610 3RD ST
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City | MACON
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State | GA
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Zip | 31201-3294
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Country | US
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Telephone | 478-254-5232
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Fax | 478-254-5232
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Authorized Official
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Title or Position | C.E.O
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Name | MR. STEPHEN BARRY
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Credential |
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Telephone | 478-342-1932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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