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General NPI Number Information
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NPI Number | 1992638209
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Entity Type | Organization
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Legal Business Name | MACON KIDNEY INSTITUTE
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Dates
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Enumeration Date | 06/05/2026
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Last Update Date | 06/05/2026
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Provider Practice Location Address
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Address Line | 1445 GEORGIA AVE STE 2
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City | MACON
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State | GA
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Zip | 31201-7610
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Country | US
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Telephone | 478-250-1325
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Fax | 478-254-6860
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Provider Business Mailing Address
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Address Line | 1445 GEORGIA AVE STE 2
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City | MACON
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State | GA
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Zip | 31201-7610
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Country | US
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Telephone | 478-250-1325
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Fax | 478-254-6860
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Authorized Official
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Title or Position | COMPLIANCE MANAGER
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Name | KAREN PRINCE
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Credential |
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Telephone | 478-250-1325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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