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General NPI Number Information
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NPI Number | 1962413559
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Entity Type | Organization
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Legal Business Name | CONCERNED CARE FOR WOMEN
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 540 CHARTER BLVD SUITE 100
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City | MACON
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State | GA
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Zip | 31210-4892
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Country | US
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Telephone | 478-474-6887
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Fax | 478-471-5292
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Provider Business Mailing Address
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Address Line | 540 CHARTER BLVD SUITE 100
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City | MACON
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State | GA
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Zip | 31210-4892
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Country | US
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Telephone | 478-474-6887
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Fax | 478-471-5292
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Authorized Official
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Title or Position | OWNER
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Name | JAMES H MITCHELL
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Credential | MD
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Telephone | 478-474-6887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 030516
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License Number State | GA
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