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NPI Code Detail

MEDICARE: JAMES J GAUDET D.C.

MEDICARE: JAMES J GAUDET D.C.
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
1111N00000XChiropractorCHIR002512GA

General Provider Information

NPI Number : 1376505917
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES J GAUDET D.C.
Provider Business Mailing Address
First Line : 3336 VINEVILLE AVE
Second Line :
City : MACON
State : GA
Zip : 31204-2328
Country : US
Telephone Number : 478-477-9480
Fax Number : 478-477-0842
Provider Business Practice Location Address
First Line : 3336 VINEVILLE AVE
Second Line :
City : MACON
State : GA
Zip : 31204-2328
Country : US
Telephone Number : 478-477-9480
Fax Number : 478-477-0842
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 10/19/2011

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