MEDICARE: IN STITCHES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	040660	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	GRP7545	OTHER	GA	MEDICARE GRP NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003952623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN STITCHES PC

Provider Business Mailing Address
First Line	:	1157 FORSYTH ST
Second Line	:	SUITE 200
City	:	MACON
State	:	GA
Zip	:	31201-7452
Country	:	US
Telephone Number	:	478-743-4321
Fax Number	:	478-330-6052

Provider Business Practice Location Address
First Line	:	1157 FORSYTH ST
Second Line	:	SUITE 200
City	:	MACON
State	:	GA
Zip	:	31201-7452
Country	:	US
Telephone Number	:	478-743-4321
Fax Number	:	478-330-6052

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LISA A FARMER
Credential	:	MD
Telephone Number	:	478-743-4321

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	01/21/2015

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Directions to “IN STITCHES PC ” Practice Location

Language	Start Address	Practice Location

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